What They Are Saying: Nursing Home Staffing Mandate is a ‘Disaster’, ‘Insanity’, ‘Catastrophic’

Members Of Congress, Medicare Policy Experts, And Local Nursing Home Advocates Say Biden Administration’s Staffing Mandate Will Limit Access To Care For Vulnerable Residents

Advocacy; Regulations; Workforce

The consensus is clear: the Biden Administration’s proposed federal staffing mandate will be impossible for the nation’s nursing homes to meet, limiting access to care for our seniors. The U.S. Centers for Medicare and Medicaid Services (CMS) released the one-size-fits-all mandate earlier this year, despite its own study finding no level of staffing guarantees quality of care. 
A recent analysis estimates that the staffing requirement would cost nursing homes approximately $6.8 billion per year to hire an estimated 102,154 additional full-time employees, jeopardizing access to care for nearly 300,000 residents.
See what members of Congress, policy and medical experts, and local nursing home advocates are saying:
“I am deeply disappointed CMS continued to move forward with this rule given the public knows their reservations regarding its efficacy. If the one-size-fits-all staffing ratios issued by CMS are put in place, it will devastate facilities across greater Minnesota, forcing them to either decrease the number of patients they serve even further, or close their doors entirely.”
“If implemented, this will result in limited access to care for seniors, mandatory increases in state Medicaid budgets, and could lead to nursing home closures, which would have an especially negative impact in rural communities, like many of the ones I represent in Indiana, that already experience health care access challenges.”
“Recommending a staffing requirement that something like 80% of facilities cannot comply with is I think best described as the definition of policy insanity.” 
“This was not a ‘bad apples’ problem, with low-staffed nursing homes having all the outbreaks and deaths. The lesson there is, staffing, as important as it is, would not prevent the next pandemic. It would not have prevented the last one.”
“This is a classic unfunded mandate and unfunded mandates just are fraught with all sorts of bad problems … [The rule would lead to] unintended consequences … that we would need to be aware of, monitor for [and] guard against. We’re likely to have some closures, and that may not be a bad thing in some locations, but … in other locations, particularly rural, that can be extremely problematic in terms of beneficiaries having access to needed services.” 
“I have an ongoing concern about how these policies are going to affect low-volume facilities, rural facilities. It would be very helpful if we could look at this data from a rural vs. urban perspective. I think it’s going to have some pretty crazy results, and we’re already very concerned about quality in rural [skilled nursing facilities] SNFs.”
“It has never been proven that cookie-cutter approaches help seniors. A blanket mandate has usually not worked so I’m very skeptical of the staffing mandate, personally … Coming up with a blanket mandate that may result in unnecessary fines and closures of nursing homes is going to create a disaster, in my opinion.” 
“It's catastrophic. There's absolutely no way to make this work. We don't have the workers to do this. This isn't the solution to the problem … There's not a nursing home that does not have openings. The cause of our current problems is that there aren't enough workers to hire. We need to create pipelines. We need immigration reform. We need more health care workers in this country. We need a greater focus on career paths, not a back-end mandate that literally cannot be met right now.” 
“The CMS-proposed staffing mandate is not the answer to the ongoing nursing home labor shortage and will only exacerbate this workforce crisis. The mandate could push nursing homes operating on already tight budgets into closing, ultimately reducing access to care. The state has already experienced a decline in access to long term care, with 17 facilities either closing or converting to a lower level of care since the beginning of 2020. This is primarily due to underfunding and the persisting staffing shortage. While nursing homes are eager to hire more staff, the fundamental issue lies in the insufficient pool of available workers. An unfunded mandate will not help nursing homes hire more staff and will likely lead to further closures. Maine’s population is the oldest in the country and is getting older. A policy like this will only further limit access to long term care, resulting in older adults and their families having to wait longer and search farther for the nursing home care they need.” 
Read what other members of Congress and local advocates are saying about the federal staffing mandate HERE, HERE, HERE, and HERE