On Friday, the Centers for Medicare and Medicaid Services (CMS) proposed new regulations that would for the first time establish federal staffing requirements on skilled nursing facilities (SNFs).
This proposed rule applies only to Medicare and Medicaid-certified SNFs, and not residential senior living communities. However, the rule has been expected for more than a year, when President Biden signaled a federal staffing mandate in his 2022 State of the Union Address.
Under CMS’s proposal, nursing homes participating in Medicare and Medicaid would be required to meet specific nurse staffing levels that promote safe, high-quality care for residents. Nursing homes would need to provide residents with a minimum of 0.55 hours of care from a registered nurse per resident per day, and 2.45 hours of care from a nurse aide per resident per day. In addition, nursing homes would also be required to ensure a registered nurse is on site 24 hours per day, 7 days per week and to complete robust facility assessments on staffing needs.
The proposed rules could have a potentially devastating impact on the long-term care industry, which will need to attract more than 20 million workers by 2040 to keep pace with our rapidly aging population. A federal mandate will only exacerbate underlying workforce issues. Ironically, the rules appear to conflict with CMS’s own detailed analysis that concludes that there is “no single staffing level that would guarantee quality care.”
The workforce crisis has actually been one of the few areas of bipartisan agreement in the first eight months of the 118th Congress. There have been numerous House and Senate committee hearings, and calls from both sides of the aisle to stem the exodus of health care workers. Argentum continues to lead public policy efforts to address the senior living industry’s workforce needs, working with congressional lawmakers to reintroduce the SENIOR Act, legislation to bolster the senior living workforce and address access and affordability of senior living, which is expected to be reintroduced this fall.
Additionally, Argentum continues to work with lawmakers on the House and Senate Appropriations Committees to secure program funding for the Department of Labor’s Employment & Training Administration, Job Corps, and the HRSA Health Workforce. These measures will help expand the workforce pipeline and enhance employee retention more than federal staffing mandates, and we encourage Congress to pass, and the president to sign, these bills.
If enacted, this proposed rule would exacerbate the skilled nursing workforce crisis, increase costs, and likely reduce access to care while the population is aging at its fastest rate in more than a century. Argentum is closely reviewing the proposed rule and supports the concerns of the skilled nursing industry on the potential negative impact to older Americans.
