Lawmakers Tussle with Nursing Home Trade Associations, Calling Their Opposition to Staffing Rule ‘Sabotage’ 

Democratic lawmakers Sen. Elizabeth Warren and Rep. Jan Schakowsky are criticizing the nursing home sector’s main trade associations for their opposition to the federal government’s minimum staffing mandate, calling their role an attempt to “sabotage” improvements in care.

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) and LeadingAge, representing thousands of facilities, have filed a lawsuit against the staffing rule, asserting it exceeds the agency’s authority and imposes insurmountable financial burdens. 

Spokespersons from both trade groups told Skilled Nursing News that they were reviewing the letters for a response.


LeadingAge said quality improvement at nursing homes is of prime importance, but it disagreed with the federal government’s approach.

“We are reviewing the letter from Senator Warren and Schakowsky regarding our position on nursing home staffing mandates,” a spokesperson said in an emailed statement. “While we oppose the final rule, we share the Biden Administration’s goal to ensure older adults’ and families’ access to quality nursing home care. Mandates are a wrong-headed approach.”

Meanwhile, AHCA called attention to the lack of funding from the federal government for the new staffing requirements. AHCA estimates that compliance with the staffing mandate would necessitate hiring 102,000 additional staff nationwide, costing an estimated $6.5 billion annually.


“For years, we have called on Washington to help address the growing caregiver shortage through targeted policies and investments, but instead of helping the profession, the Administration issued an unfunded and unrealistic mandate,” AHCA said in an emailed statement. “These blanket requirements do nothing to help us develop, recruit, and retain caregivers, and only stand to limit access to care for America’s seniors. This is why you’ve seen overwhelming and bipartisan opposition throughout our diverse profession and on Capitol Hill. Our commitment to preserving access to care will remain unwavering, and we hope to work with Washington on more productive and meaningful solutions.”

The Centers for Medicare and Medicaid Services (CMS) finalized in April its rule for minimum staff-to-patient ratios, requiring a registered nurse on-site 24/7 in nursing homes across the United States.

In the letter, shared exclusively with The Hill, Warren and Schakowsky condemned the industry groups for what they perceive as prioritizing financial interests over the well-being of nursing home residents.

“The basis of the nursing home industry’s opposition to this rule appears to be quite simple: greed,” the letter states. “Industry claims that nursing homes cannot afford to hire more nurses are undermined by a recent investigation by our offices, which found that for-profit nursing homes have been stuffing hundreds of millions of dollars into their pockets with sky-high executive salaries, massive dividends, and large stock buybacks.”

The industry’s opposition to the rule includes concerns that it could lead to closures or reduced capacities in nursing homes.

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