Nursing home leaders are hoping that the Department of Health and Human Services’ (HHS) new chief, Robert F. Kennedy Jr., who was sworn in on Thursday, will commit to protecting Medicare and Medicaid and undoing the federal staffing mandate.

Republican lawmakers are pushing for potential Medicaid cuts in their spending bill due to be finalized in April. In his confirmation hearing in late January, Kennedy said he wasn’t planning on “dismantling” the program. At the same time, Kennedy raised concerns over the practicality of the nursing home staffing mandate, highlighting the link between the mandate and access to care, especially in rural communities.

The proposal from House Republicans seeks to find $880 billion in cuts to Medicaid, according to a report from NPR, with states likely to cut benefits and limit eligibility. Medicare might also be in for cuts as well.

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) President and CEO Clif Porter said he believes Kennedy will protect Medicaid and Medicare for long-term care.

“[W]e want to thank Secretary Kennedy for his commitment to protecting Medicare and Medicaid—programs that the majority of our residents rely on to cover their daily care,” Porter said. “Proper federal resources and policies can help us strengthen the care being delivered and support those who deliver it.”

Porter said that he is excited to begin working together with the new HHS secretary, and supporting the Trump administration’s mission to “make America healthy again.”

“As the largest association representing nursing homes and assisted living communities, we uniquely understand the rippling effect of poor health,” said Porter. “Our residents and patients are coming to our long-term care facilities later in life with more chronic diseases, requiring higher intensities of care and support.”

Improving health outcomes earlier in life – something Kennedy supports – will help increase seniors’ quality of life while also reducing the burden on caregivers, the health care system and taxpayers, Porter said.

Nursing home associations seek to work with the new HHS secretary to foster quality improvement and protect access to long-term care, as the elderly population rapidly grows, and they hope the staffing mandate will be derailed. 

“We do know, from press reports, that the rule’s repeal is on Congress’s list for budget reconciliation options,” said Linda Couch, senior vice president of policy at LeadingAge. The association looks forward to sharing their agenda with Kennedy, and the rest of the HHS team, she said.

The vote to confirm Kennedy was largely along party lines – 52 Republicans to 48 Democrats – with Sen. Mitch McConnell being the only Republican to vote against Kennedy.

During his confirmation hearings, Kennedy called out the federal staffing mandate’s 24/7 registered nurse (RN) requirement, believing the rule would create hardships for facilities.

“These are staffing rules that require 24-hour staffing by medical professionals. Some of the nursing homes in rural areas simply do not have the available personnel or the economics,” Kennedy said during his hearing. “[This] means the parents, the elderly parents, will be moved a great distance from the local community and their family. And we know that the single greatest driver of high quality nursing home care is the proximity of family.”

Meanwhile, Kennedy’s vaccine skepticism, including his past comments on the use of COVID-19 vaccines, was a subject of scrutiny from Senators.

Vaccines aside, infection prevention protocols remain an important feature of curbing spread of disease in nursing homes. And for its part, the Association for Professionals in Infection Control and Epidemiology (APIC) wrote to Kennedy upon his confirmation, urging the new HHS secretary to expand on infection prevention and control (IPC) reporting and staffing in nursing homes, among other requests.

“The COVID-19 pandemic had devastating consequences in nursing homes, demonstrating the critical importance of robust infection prevention and control practices to protect residents from COVID-19 and other infectious diseases,” an APIC spokesperson said.

With Kennedy confirmed, nursing home leaders now look to the potential confirmation of the Centers for Medicare & Medicaid Services’ (CMS) secretary, Dr. Mehmet Oz, a heart surgeon and long time television personality. The hearing date for Oz’s confirmation hasn’t been scheduled yet.