Bipartisan lawmakers oppose White House nursing home staffing proposal

Nearly 100 House members are calling on the Biden administration to reconsider a proposed rule to set a minimum staffing standard for nursing homes.

In a bipartisan letter sent Friday led by Rep. Greg Pence (R-Ind.), the lawmakers said the rule would result in “limited access to care for seniors, mandatory increases in state Medicaid budgets, and could most consequentially lead to widespread nursing home closures.”

Among other provisions, the policy would require facilities to have a registered nurse on staff 24 hours per day, 7 days per week. Current federal law requires nursing homes to have a registered nurse on duty for 8 consecutive hours per day, 7 days a week, and to have a licensed nurse — who is either an RN or licensed practical nurse — on site 24/7. 

The proposal has angered groups on both sides of the issue. The nursing home industry said it would be too burdensome and reduce access to care, while patient advocates argue the rule isn’t stringent enough. 

Industry groups argue a federal standard is unfeasible because of a nationwide staffing shortage made worse by the pandemic. They say it also amounts to an unfunded federal mandate because Medicaid reimbursement rates are too low. 

According to an analysis by KFF, fewer than 1 in 5 nursing facilities could currently meet the required number of hours for registered nurses and nurse aides.

The House letter echoed many of industry’s concerns, and argued the proposal would have a negative impact on the ability of nursing homes “to recruit and retain qualified nursing professionals at a time in which the health care industry, specifically the long-term care sector, is facing workforce shortages at unprecedented levels.”