Earlier today, the Centers for Medicare & Medicaid Services (CMS) announced that it is now accepting applications for the Guiding an Improved Dementia Experience (GUIDE) Model, a package of care coordination and management, caregiver education and support, and respite services to improve the quality of life for people living with dementia, reduce strain on unpaid caregivers, and help people remain in their homes and communities.

In observance of Veterans Day, the U.S. Senate Special Committee On Aging is holding a field hearing in Tampa, Florida today at 2:00 p.m. ET on "Issues Facing Veterans: Access to Care, Services, and Economic Opportunity."

Today's field hearing presents an opportunity for senior living advocates to get our voices heard on the need for Congress to pass the Expanding Veterans' Options for Long Term Care Act (H.R. 1815, S. 495). This bipartisan legislation would finally give veterans the ability to choose assisted living for their long-term care, instead of a nursing home.

In response to the proposed rule issued by the U.S. Department of Labor in September, Argentum and the American Seniors Housing Association (ASHA) sent a joint comment letter urging the department to withdraw the rule and work with stakeholders to develop solutions for overtime pay that more closely reflect current economic conditions.

Voters are heading to the polls today in several states, with governors races on the ballot in two states, legislature elections in three states, municipal elections in 64 cities/counties, and ballot measures in five states (Colorado, Maine, New York, Ohio, and Texas). Notable races include:

• Kentucky: Governor Andy Beshear (D) is seeking a second term, challenged by Attorney General Daniel Cameron (R).
• Mississippi: Governor Tate Reeves (R) is seeking a second term, challenged by Public Service Commissioner Brandon Presley (D). All 174 seats in the legislature (house and senate) are also up for election. Republicans currently control the Senate 36-15, and the House 76-40.
• New Jersey: All 120 seats in the General Assembly (house and senate) are up for election. Democrats currently control the Senate 25-15, and the House 46-34.
• Rhode Island: Special election for the 1st congressional district, formerly held by David Cicilline (D), who resigned in May to lead the Rhode Island Foundation.
• Virginia: All 140 seats in the General Assembly (house and senate) are up for election. Democrats currently control the Senate 22-18, Republicans currently control the House 52-48.

Argentum joined with a coalition of industry stakeholders to submit comments in response to the proposed rule issued in September that would establish federal staffing requirements on long-term care facilities. The rule would apply only to Medicare and Medicaid-certified skilled nursing facilities (SNFs), and not residential senior living communities.

Under CMS’s proposal, nursing homes participating in Medicare and Medicaid would be required 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. CMS would also impose new reporting requirements for states to report on the percentage of nursing home Medicaid payments that go to compensation for direct care workers and support staff.

Our comments specifically called attention to potential unintended impacts of the rule on settings that are otherwise not directly impacted, due largely to the long-term care industry's workforce shortages. Earlier this year, Argentum released a report showing a need to recruit more than 20 million workers by 2040 to keep pace with our rapidly aging population. We argued in our comments that imposing a minimum staffing standard will not create more caregivers; it will simply further exacerbate the current shortage.

Last Wednesday, Argentum participated in the Global Brain Health and Longevity Initiative hosted at the U.S. Capitol by Social Impact Partners. The event featured leaders in for-profit, nonprofit, governmental, other sectors focused on setting strategies in addressing dementia through brain health legislation, corporate innovations, workforce imperatives, and other opportunities.

Speakers included Argentum President and CEO James Balda, industry stakeholders including George Vradenburg from UsAgainstAlzheimer’s and Dr. Sandi Chapman from the Center for BrainHealth at UT Dallas, and Senators Corey Booker (D-NJ), Amy Klobuchar (D-MN), and Kirsten Gillibrand (D-NY). Both Klobuchar and Gillibrand spoke of their personal connection to family members in assisted living.

Argentum released a statement today in response to the news that all charges against Silverado Senior Living have been dropped and the case has been dismissed.

Yesterday, a Los Angeles circuit court judge summarily dismissed the 13 felony counts of elder endangerment and five felony counts of violation causing death in connection with 14 COVID-related deaths that occurred at Silverado Beverly Place in March 2020, during the earliest days of the COVID-19 pandemic. The indictments had charged both Silverado and CEO Loren Shook, Vice President Kim Butrum, and former Silverado Beverly Place Administrator Jason Russo.

Earlier today, the National Labor Relations Board (NLRB) issued a Final Rule on the Standard for Determining Joint-Employer Status under the National Labor Relations Act. The rule replaces the final rule issued in 2020, which had itself modified the standard adopted during the Obama Administration. The new rule will take effect on December 26, 2023 (click here to view a fact sheet on the rule).

Under the new standard, an entity may be considered a joint employer of a group of employees if each entity has an employment relationship with the employees and they share or codetermine one or more of the employees’ essential terms and conditions of employment, which are defined exclusively as:

Three weeks after Rep. Kevin McCarthy (R-CA) was ousted from his role as Speaker of the House, and after three Republicans were nominated but could not win the necessary votes to be elected, the House has finally elected Rep. Mike Johnson (R-LA) to be the 56th Speaker, capping off a chaotic month that has paralyzed the House.

House Republicans nominated a new candidate for speaker late last night, Rep. Mike Johnson (R-LA). Johnson had only hours earlier narrowly lost his bid for the speaker nomination to Rep. Tom Emmer (R-MN) in the fifth round of voting among party lawmakers; however, just four hours after securing the nomination, Emmer announced he would withdraw from consideration as more than two dozen House Republicans indicated they would not support him on the floor and thus he had not path to being elected.

It is clear that this process remains far from over. To help make sense of it all, and what it means for senior living policy priorities, Argentum Advocates are invited to join us for our monthly policy briefing this afternoon.

Argentum Advocates Member Briefing
Wednesday, October 25, 2023
2:00 PM ET

• A profile of Rep. Johnson and expectations for a floor vote to elect him speaker, and how he might lead the chamber;
• A preview of the upcoming fall agenda in Congress, including how we are working to defeat proposed cuts to critical workforce programs as lawmakers resume negotiations on spending bills ahead of the November 17 funding deadline;
• An update on our priority legislation, including the Veterans assisted living pilot program, workforce development programs, the SENIOR Act, and intergenerational opportunities;
• A look at our regulatory outreach and status of pending administrative actions.