28 Senators Push CMS to Scrap Nursing Home Staffing Mandate

In a bipartisan effort, U.S. Senators Jon Tester (D-MT) and James Lankford (R-OK), along with 26 other senators, penned a letter to Chiquita Brooks-LaSure, Administrator of the U.S. Centers for Medicare & Medicaid Services (CMS), urging the Biden Administration to reconsider the proposed federal staffing mandate.

The senators expressed their collective concern that, amid an unprecedented workforce crisis, the proposed federal mandate may exacerbate the challenges faced by long-term care facilities.

“In many parts of the country, America’s long-term care facilities are facing severe workforce shortage issues that are harming access to critical care for our nation’s seniors,” they wrote. “With this in mind, we are deeply concerned that now is the worst possible time for the United States to establish the nation’s first federal staffing mandate for long-term care facilities.”


Senators called the proposal “overly burdensome” and said it could result in additional closures and decreased access to care.

“We urge you to rescind CMS’ proposed rule and instead commit to working with Congress on the large number of alternate solutions to quality of care in skilled nursing facilities,” they wrote.

One of the critical points made in the letter is that a recent study from CMS itself found that staffing levels do not necessarily guarantee the quality of care provided in nursing homes. The report highlighted disparities in staffing between different facilities and regions and raised concerns about the feasibility of implementing national requirements.


Senators argued that establishing federal staffing standards might not provide the flexibility needed by nursing homes, particularly in rural and underserved areas.

“If large, urban, multistate hospital corporations are having trouble hiring nurses, there is no doubt that this struggle will only be amplified for small rural nursing home providers,” they wrote.

Leaders with nursing home providers and industry advocates have raised many of the same objections cited by the federal lawmakers in their letter, including the lack of flexibility inherent in a one-size-fits-all rule. CMS currently is collecting public comments on the proposal, and advocacy efforts are a major focus of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) annual conference taking place this week in Denver.

“We need your help one more time,” AHCA CEO Mark Parkinson said on Monday. “I have a strong belief that we will get it — people have already stepped up. We’ve received thousands of comments.”

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