Senators Blast Nursing Homes’ Staffing Proposal in Finance Meeting, Citing Lack of Funding, Staff

Some Republican senators blasted the Department of Health and Human Services’ (HHS) minimum staffing proposal for nursing homes in a recent finance committee meeting, noting the paltry $75 million to bolster staffing isn’t enough to support upcoming regulations.

Sen. John Barrasso (R-Wyo.) pointed out that four of five facilities won’t be able to comply with the rule as it stands, and that the $75 million may not be seen by rural communities that need it most, according to a report from MedPage Today.

The Centers for Medicare & Medicaid Services (CMS) minimum staffing proposal calls for Medicare- and Medicaid-certified nursing homes to provide a minimum of 0.55 hours of care from registered nurse per resident per day and 2.45 hours of care from a nurse aide per resident per day, with non-rural nursing homes having three years and rural nursing homes five years to meet these standards.


Major contentious aspects of the proposal include the absence of licensed practical nurses (LPNs), inadequate commensurate funding at $75 million, and a requirement to have a registered nurse (RN) on staff 24/7.

The proposal is set to be finalized in 2024.

“The hardship exemption for rural communities who can’t find people to hire — even though they try very hard — is requiring much more paperwork,” Barrasso said during the meeting. “Most of the Wyoming nursing homes that I talk to, they would have to actually hire additional staff, not in addition to taking care of the patients, but to just fill out the paperwork that your department is requiring.”


Becerra told the committee that CMS has worked to try to ensure the funding reaches communities most in need.

Still, for a nursing home to call itself a nursing home, it must have a nurse present to provide care to residents, and give loved ones peace of mind, Becerra said. He reminded the committee that one in five people who died from Covid did so in a nursing home.

Barrasso countered that only one in five can meet proposed requirements right now.

“Even those trying to hire people can’t find people to fulfill it. So four out of five nursing homes are going to be out of compliance with administration rules,” Barrasso said.

Legislation to block the proposal reached another milestone earlier this month, as the U.S. House Ways and Means Committee passed the Protecting America’s Seniors’ Access to Care Act. First introduced by Rep. Michelle Fischbach (R-MN), the bill aims to prevent CMS from finalizing the proposal. There’s a companion bill in the Senate.

The Senate Finance Committee also touched on the Inflation Reduction Act (IRA) of 2022 that allows Medicare to negotiate lower drug prices directly with drug manufacturers – the proposed HHS budget would allow negotiations for another 50 drugs each year, up from 10 in 2024. Some of the impacted drugs are used in nursing homes.

Crapo said the move would polarize members in both chambers.

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