Legislation To Overturn CMS’ Nursing Home Staffing Mandate Introduced in Congress

A Congressional Review Act (CRA) to overturn the federal government’s minimum staffing rule for nursing homes was introduced on Tuesday by Representatives Michelle Fischbach (R-Minn.) and Greg Pence (R-Ind.).

The legislation aims to reverse the Centers for Medicare & Medicaid Services’ (CMS) staffing mandate. 

“The CRA represents a joint resolution (simple majority that can’t be filibustered) of disapproval between both chambers,” Scott Fidel, investment analyst at Stephens Inc., wrote, adding, “It must be signed by the President to overturn agency rules, which seem impossible … since this is Biden’s own rule. However, if Trump is elected, this CRA would likely have much more favorable prospects of getting signed into law.”


If enacted, the CRA will bar CMS from issuing another rule in “substantially the same form” as the disapproved rule, Fidel said.

Rep. Fischbach criticized the staffing mandate as a “half-baked, one-size-fits-none plan” that fails to address the ongoing nursing staff shortage and could potentially harm nursing home facilities across Minnesota’s Seventh District.

“This administration has been insistent on moving forward with this rule, despite the fact that a report commissioned by CMS itself found that there is no single staffing level that guarantees quality care,” she said in a press release. “They also know that the new mandated ratio will force facilities to turn away patients or even close their doors altogether. I am committed to holding the government accountable and I am proud to introduce this CRA to overturn a potentially disastrous policy. I hope to work with HHS and stakeholders on policies that support recruitment and retention to solve the ongoing nursing shortage in this country.”


Similarly, Rep. Pence expressed concerns about the timing and impact of the rule, stating that it could worsen healthcare worker shortages instead of offering a viable solution.

“Since it was proposed, I have continuously urged the Biden administration to reconsider and think about the Americans whose access will be threatened. Clearly, implementing unworkable standards is short-sighted and negligent. We cannot let this stand,” Pence said.

Nursing home advocates, who warn that the staffing mandate will create access issues, welcomed the legislation challenging the mandate.

Katie Smith Sloan, president and CEO of LeadingAge, thanked Rep. Fischbach for leading the initiative.

“The final rule, while well-intentioned, will not achieve the sought-after goal of ensuring older adults’ and families’ ability to access quality nursing home care,” Smith Sloan said in a press release. “Two major issues – the ongoing workforce shortage and cost of recruiting, training and retaining staff – mean that implementation could very well have unintended consequences of further exacerbating existing challenges including limited admissions, fewer available beds and worse yet, nursing home closures, that are limiting care access.”

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