Citing Worries Over ‘Reduced Capacity’ at Nursing Homes, AHA Lends Voice To Halt Staffing Mandate 

The American Hospital Association (AHA) is lending its voice to the fight against the minimum staffing mandate, and joining hands with nursing home organizations as well as a coalition of lawmakers to overturn the federal government’s rule.

By sending a letter to lawmakers Monday, AHA boosted the bipartisan bid to halt the staffing mandate through the Congressional Review Act (CRA).

The measure is gaining traction and has amassed enough votes and support in both the Senate and the House to pass. However, even if the CRA passes in both chambers, President Joe Biden is widely expected to veto it. And, in order to eventually survive the veto, the CRA needs to have a two-thirds House and Senate majority.


In its letter AHA highlighted the likelihood of losing nursing homes beds, worsening the hospital discharge crisis, which has led to patients languishing at hospitals.

“[T]his final rule could lead nursing homes to reduce capacity or close outright, including those that are otherwise performing well on quality and safety metrics. The loss of these nursing home beds could adversely impact patients who have completed their hospital treatment and need continuing care in nursing facilities,” AHA’s executive vice president, Stacey Hughes, stated in the letter.

Hughes also undermined the rationale behind CMS’ final rule.


“The process of safely staffing any health care facility is about much more than achieving an arbitrary number set by regulation. It requires clinical judgment and flexibility to account for patient needs, facility characteristics and the expertise and experience of the care team,” Hughes stated in the letter, adding that the “one-size-fits-all minimum staffing rule … creates more problems than it solves.”

Officials from the American Health Care Association (AHCA) praised AHA’s backing of legislative efforts to defeat the staffing mandate.

“This mandate will not only worsen the workforce crisis for nursing homes, but it will also cause a negative ripple effect on the entire health care system as nursing homes are forced to limit admissions or close their doors altogether,” Clif Porter, SVP of Government Relations at AHCA/NCAL, said in an emailed statement to Skilled Nursing News. “This is the result of implementing a mandate on a sector that simply does not have the pool of caregivers needed to meet the demands, and it will end up impacting access to care for seniors in communities across the country.”

Porter said that AHCA continues to support the two pieces of legislation that would block the staffing mandate, namely, Protecting America’s Seniors’ Access to Care Act in addition to the CRA resolution.

“We appreciate AHA’s support and will keep at the fight to overturn this unrealistic and out-of-touch mandate,” he said.

Meanwhile, legal efforts to rescind the staffing mandate are also underway. A joint lawsuit led by AHCA, with backing from LeadingAge and various nursing home operators, has also been filed against federal agencies. And, legal analysts believe the lawsuit has a good chance of succeeding.

In applauding AHA’s effort to dismiss the mandate, a LeadingAge spokesperson underlined worries over access to care and backlogs at hospitals.

“[The staffing mandate] will, without question, impact the ability of our nursing home members to provide care and services – but nursing homes will not be alone in that,” the spokesperson said. “Home health providers are already rejecting referrals and some face closure due to financial pressures and workforce shortages. Hospitals will continue to be backed up with patients who can’t be discharged to nursing homes … We are pleased to see the American Hospital Association agrees with our stance and opposes the rule.”

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