Nursing Home Leaders Using ‘All the Tools Available’ in Aggressive Push to Halt CMS Staffing Mandate

LeadingAge joins a slew of other nursing home industry voices in urging a multi-faceted strategy following the finalization of the federal minimum staffing rule a month ago. The advocacy group is pursuing legislative, legal and regulatory avenues to stop the mandate and build the workforce.

Katie Smith Sloan, president and CEO of LeadingAge, said, “We are pursuing an aggressive, multi-faceted strategy employing all the tools available to us” to address both the fundamental issue of building the long-term care workforce while also stopping implementation of the rule. More information will be shared soon, according to a LeadingAge statement.

Meanwhile, the American Health Care Association (AHCA) has noted bipartisan momentum building against the rule. The association seeks to work with lawmakers on more meaningful solutions to boost the workforce. The association has also been crunching the numbers, providing an updated cost for the rule – as is, the rule would cost $6.5 billion annually and require 102,000 additional caregivers.


Finance leaders including Sabra Health Care REIT (Nasdaq: SBRA) have said the sector was left with no choice but to challenge the rule, with the premature release showing a lack of consideration given to thousands of comments submitted against it.

“For months prior to the April 2024 nursing home staffing mandate final rule announcement, we urged the Centers for Medicare and Medicaid Services (CMS) to get long-term care workforce issues right,” Smith Sloan said in a statement. “And yet, the agency has not. In fact, it is careening down a path that will have devastating consequences on older adults’ and families’ ability to access care and services.”

There’s no way CMS could have thoughtfully reviewed the 50,000 comments on the rule, not with the model which was finalized, noted Matros. He points to legislative action and potentially legal action as well.


Some legislative action has been taken already, most recently with the introduction of the Congressional Review Act on May 15 to overturn the rule via a congressional appropriations process to block funding for the rule’s implementation. There’s also the Protecting America’s Seniors’ Access to Care Act, which would block the mandate; it’s been moving through committees since its introduction last October.

Omega Healthcare Investors Inc. (NYSE: OHI), another real estate investment trust (REIT), said constructive industry ideas and comments were not utilized in the finalized rule, including the use of technology and certain best practices.

But, the REIT remains cautiously optimistic given the rule’s long lead time of several years, depending on whether a facility falls in a rural area or not.

Moreover, PACS Group (NYSE: PACS) CEO Jason Murray told Skilled Nursing News that the company will support and invest in efforts to get the rule repealed or further refined to become more palatable. That means lobbying on the national and state level with associations like LeadingAge, along with its own efforts.

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