Governors say CMS staffing rule would close nursing homes

(The Center Square) – A proposed long-term care staffing rule from the Centers for Medicare and Medicaid Services would not improve care but would force nursing homes to close, 14 Republican governors said in a letter to CMS.

The rule changes would require long-term care facilities to conduct a facility assessment that includes a staffing plan within 60 days of the rule’s implementation. The second phase of the rule mandates a registered nurse must be onsite 24 hours a day.

The final element of the rule would require a registered nurse on site for 0.55 hours per resident day and nurses aides onsite for 2.45 hours per resident. It would be implemented three years after the final rule is published.

The governors said the rule would lead to a crisis in the long-term care industry.

“America’s long-term care industry is facing a full-fledged workforce crisis, hitting lows not seen since 1994,” the governors said in the letter. “Between February 2020 and December 2022, facilities lost more than 200,000 workers, and industry observers view long-term care as among the hardest hit sectors in healthcare that has still not recovered from the COVID-19 pandemic. Such challenges are especially acute in rural areas. Despite this, the CMS requirements would force over 80% of facilities nationwide to hire more staff at a time when workers, particularly RNs, have never been scarcer.”

The requirements could force nursing homes to close, they said.

The Iowa Health Care Association agrees. Twenty-seven nursing homes have closed in Iowa since 2022, according to the association, which represents 318 nursing homes and other long-term care facilities across the state.

“The CMS rule issued today to enforce the Administration’s proposed mandate will needlessly exacerbate the extraordinary health care workforce crisis, tear at the fabric of our rural communities, and threaten access to long-term care services for Iowans who depend on those services to meet their most basic human needs,” said IHCA president and CEO Brent Willett the day the rule was released. “Today’s rule, if allowed to stand, will result in further closures, introducing needless trauma into the lives of residents and preventing access to care for rural Iowans who deserve it.”

The comment period for the rule ends Monday.

The letter is signed by the governors of Iowa, Nebraska, Georgia, Indiana, Mississippi, Missouri, Montana, Nevada, New Hampshire, Oklahoma, South Carolina, South Dakota, Tennessee, Texas and Wyoming.