What They Are Saying: Lawmakers & Long Term Care Leaders Continue To Voice Opposition To Federal Staffing Mandate For Nursing Homes

Advocacy; AHCA/NCAL Updates; Legislative; Workforce

​During a recent U.S. House Energy and Commerce Subcommittee on Health hearing, “Legislative Proposals to Increase Medicaid Access and Improve Program Integrity," lawmakers expressed extreme concern over the Centers for Medicare and Medicaid Services' (CMS) recent finalization of the federal minimum staffing rule for nursing homes.

Members of the subcommittee explained how a one-size-fits-all government mandate does nothing to help nursing homes recruit and retain more caregivers and will only limit access to care for seniors by causing facilities to limit their admissions or close altogether.

See below what lawmakers said at the hearing:

Chairwoman of the Committee Cathy McMorris Rodgers (R-WA-05):

“Unfortunately, while we continue to develop bipartisan, legislative solutions, the Biden Administration is making it more difficult in some instances for people who have disabilities to access care. By setting unattainable staffing requirements, I fear that the minimum staffing rule will force nursing homes to close or reduce the number of seniors served."


Chairman of the Subcommittee Brett Guthrie (R-KY-02):

“I'm extremely concerned about two of these rules, in particular the nursing home minimum staffing rule and the Medicaid access rule, both of which threaten access to long term care services for Medicaid beneficiaries by setting arbitrary staffing and pay standards. While I agree that we need to do more to ensure our frontline caregivers and clinical care providers are compensated commensurately with the care they're providing and offer a better quality of life for our most vulnerable, this approach simply won't work. These rules come in a time when we have seen more than 500 nursing home facilities close since the start of the pandemic, and where we have 150,000 fewer long term care workers than we did before 2020."​

Vice Chairman of the Subcommittee Larry Bucshon (R-IN-08):

“Let me just say this federal staffing mandate will backfire, facilities will close. The staff just are not available. Facilities across my district have told me so. They all have job postings. They all want more people … The employees just are not there. You cannot expect salaries to increase when Medicaid is the main provider and Medicaid reimbursement isn't increasing, it just doesn't work."

U.S. Representative Bob Latta (R-OH-05):

“Recently, the Biden Administration finalized their mandatory staffing ratios for nursing homes. Portions of my district are extremely rural, finding staff for certain jobs can be difficult, particularly in health care. Independent reports show that 80 percent of nursing homes cannot comply."

U.S. Representative Buddy Carter (R-GA-01):

“I've seen the struggles of nursing homes firsthand, and that's why I'm so concerned about the nursing home minimum staffing standard rule and, you know, when it comes down to it, and I've often said this, we all, whether it be Republican or Democrat or an Independent, we all want the same thing. We want accessible, affordable quality health care. Everyone wants that. And I'm worried about the accessibility of this. I'm worried about what impact that this rule is going to have on accessibility for senior citizens to the nursing home setting and it's been estimated in Georgia that [this] is going to result in 10,000 senior citizens not being able to be in a nursing home."​

As lawmakers continue to sound the alarm, long term care leaders across the country have also raised concerns. Mark Parkinson, the president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), went on NPR's All Things Considered where he said:

“There is a shortage of nurses across the country, but it is the most acute in skilled nursing facilities. The administration has done nothing to help us with the staffing crisis. And then to add on top of that, and a requirement that we need to hire an additional 120,000 nurses as well, which is what the number is, would make it impossible … We're not against more staffing. Believe me every nursing home in the country is out there right now hustling and advertising to get more staff. But what we are against is an impossible policy that when it is enforced will cause hundreds and possibly thousands of nursing homes to close."


Rick Abrams, executive director of the Wisconsin Health Care Association and Wisconsin Center for Assisted Living (WHCA/WiCAL), was interviewed on PBS Wisconsin where he explained:

“…if a facility cannot achieve the 3.48 hours per resident day, if they're not in a position to reduce the number of occupied beds, what that does is it puts more pressure on the staff that is there and the biggest concern that I have with that is that that is going to hasten burn-out and that is going to hasten the exodus of these good and dedicated people from our sector, and nobody can afford that. … We just don't think a black-and-white, cookie-cutter, however you want to describe it, minimum staffing standard is the right approach."​

See what more lawmakers from both sides of the aisle, policy experts and long term care advocates have said about the federal staffing mandate HERE.