AHA Urges Congress to Block CMS from Enforcing Minimum Staffing Requirements for Nursing Homes

This week, the American Hospital Association (AHA) sent letters to the Senate and House urging them to support legislation that would prevent the Centers for Medicare & Medicaid Services (CMS) from enforcing its final rule on minimum health care requirements. staffing for long-term care facilities. .

The organization argued that establishing minimum staffing requirements would stifle innovation in care delivery and could potentially lead nursing homes to reduce capacity or close their doors entirely, even if they obtain good results in terms of quality and safety.

CMS’s rule — which was finalized in April — requires all nursing homes that receive federal funding through Medicare and Medicaid to provide 3.48 hours of daily direct care per patient. It also requires that nursing homes must have at least one registered nurse on site 24 hours a day – a significant increase from the eight hours per day previously required by federal law.

The rule also states that 0.55 hours of this daily care must be provided by a registered nurse, and 2.45 hours of this care must be provided by nurse aides.

That means a facility with 100 residents would need at least two or three registered nurses each day, as well as 10 to 11 nurse’s aides and a pair of additional nurses, according to a fact sheet from the White House.

In its letter to the Senate, the AHA wrote that safely staffing any healthcare facility “goes well beyond meeting an arbitrary number set by regulation.”

“This requires clinical judgment and flexibility to take into account patient needs, facility characteristics, and the expertise and experience of the care team. (CMS) single minimum staffing rule for long-term care facilities creates more problems than it solves and could compromise access to all types of care across the continuum, especially in rural and underserved communities that may not have the workforce levels to meet these requirements,” the letter states.

In both letters, the AHA called on Congress to disapprove the mandate and prohibit CMS from implementing or enforcing it.

The rule has received negative feedback from the nursing home industry since it was proposed last September.

For example, the American Health Care Association (AHCA) released a statement saying the staffing mandate sets “an unreasonable standard that only threatens to close more nursing homes, displacing hundreds of thousands of residents and restricting elderly people’s access to care.”

The AHCA also pointed out that some states have already adopted staffing mandates for nursing homes — and that facilities in those states have largely struggled to comply. For example, three-quarters of New York’s nursing homes do not meet the state’s requirement to provide three and a half hours of care per resident per day, the organization said.

Unions are the only entities that seem satisfied with the proposal. For example, the Service Employees International Union (SEIU) welcomed the rule, calling it “a major step toward strengthening our long-term care workforce, ensuring quality care for those who need it and helping every family to prosper.”

Photo: Kiwis, Getty Images