‘Deeply Flawed’: LPNs Speak Out On Their Exclusion from Nursing Home Staffing Proposal

As advocacy efforts to oppose the federal government’s proposed staffing mandate continue, the National Association for Licensed Practical Nurses (NALPN) is lending its voice towards the withdrawal of the mandate by sharing a joint letter it sent to the federal agency.

The role of licensed practical nurses (LPNs) has been chopped off from the proposal, a stipulation contested in the letter addressed to the Centers for Medicare & Medicaid Services’ (CMS) administrator, Chiquita Brooks-LaSure.

“It is evident that LPNs are essential members of a coordinated care team, [and] yet the proposed federal staffing mandate gives absolutely zero credit to the vital role they play as licensed nurses. To not include LPNs with RNs is an affront to their hard work and dedication to the residents they serve,” the letter states.


The exclusion of LPNs shows how “deeply flawed” the proposed rule is, the letter further states, arguing that this move will discourage certified nursing assistants (CNAs) from seeking career advancement. Moreover, the rule also ignores the efficiencies gained from a collaboration between the different levels of nursing staff.

Currently, more than 170,000 LPNs work in nursing homes, making up 13% of the nursing home workforce. Meanwhile, nursing homes are the largest employers of LPNs, with 35% of all LPNs working in nursing homes and residential care settings.

“We are requesting the administration to withdraw this archaic, unfunded health care policy and instead focus on meaningful, supportive ways to grow and retain the nursing home workforce,” the letter notes, adding, “LPNs should be recognized and regarded with RNs as nurses—that’s what they are. This means any RN requirement should include all worked hours of LPNs in it, as both are licensed nurses. These are integral and valued members of our nursing homes, and they should be treated as such.”


Along with NALPN, several other industry associations, including the two largest industry groups – LeadingAge and the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) the American Association – signed the letter. The comment letter was among more than 46,000 comments CMS received during the 60-day comment period.

Other signatories on the letter included the American Assisted Living Nurses Association (AALNA), LeadingAge, National Alliance of Wound Care, Association of State Veterans Homes, and National Rural Health Association.

In addition to including LPNs, AHCA notes that in order to improve quality of care, “the Biden Administration and federal lawmakers should instead focus on supportive policies and programs that will actually help nursing homes build a strong pipeline of caregivers. A one-size-fits-all mandate that does not even recognize all of the essential caregivers who contribute to resident care is entirely the wrong approach.”

NALPN has represented LPN’s/LVN’s in the United States and Puerto Rico for the past 75 years.

Companies featured in this article:

, , , , ,