Republicans are expected to roll back the Biden administration's controversial nursing home staffing rules before they take effect.
The measure would come as a relief to the nursing home industry, which has argued that the mandate does not adequately address current workforce challenges. But consumer advocates and public health experts who have fought to keep the rule in place are concerned that repealing it will have a negative impact on both residents and long-term care facility staff.
More than 200,000 nursing home and long-term care facility residents died in the first two years of the COVID-19 pandemic, and the spread of the virus and resulting deaths are linked to staffing shortages.
In response, the Biden administration proposed the following: three reforms This includes establishing national minimum staffing requirements.
As part of the rules establishing that requirement, finalized earlier this year, nursing homes will be required to provide all residents with at least 3.48 hours of nursing care per day, including at least 0.55 hours of certified nursing care. and 2.45 hours of nursing care. Care from a nursing assistant.
Nursing homes will also be required to have a registered nurse on-site 24 hours a day, seven days a week to provide life-saving care to residents.
The rule faces bipartisan opposition, with Republicans in particular strongly opposed to staffing requirements.
Lawmakers from both houses of Congress filed a joint resolution under the Congressional Review Act (CRA) to overturn the rule within months of its final decision..
“Critical workforce and nursing shortages are already hampering access to care, and the Biden administration will only make things worse,” said the ranking member of the Senate Health, Education, Labor, and Pensions Committee. Sen. Bill Cassidy, R-La., said in a statement after becoming a co-sponsor of the Senate bill. James Lankford (R-Okla.) and Joe Manchin (Idaho-Va.). “We strive to ensure that seniors have access to quality care when they need it.”
Neither resolution was passed, and the rules are currently scheduled to fully take effect in 2027 for urban facilities and 2029 for rural nursing homes.
Republican lawmakers want to repeal the rule entirely as part of a preliminary proposal to add health care policy to a continuing resolution that Congress aims to pass by Dec. 20 to avert a government shutdown. proposed.
And there are multiple ways that it could be blocked or completely reversed under the incoming Trump administration.
Lawmakers in the House and Senate, soon to be controlled by small Republican majorities, could pass legislation like the Late Night Rule Relaxation Act. The bill would amend the CRA and allow Congress to overturn federal regulations enacted in the final year of the current administration. instead of the current 60-day look-back period, according to leading age, a nursing home industry group.
Lawmakers can also use the budget and spending process to block implementation of the rules.
In addition, the Trump administration may enact new rules that would roll back or repeal current rules, according to the health policy nonprofit KFF.
“This would have to go through the rulemaking process, but ultimately the provisions of the rule could be rescinded,” said Priya Chidambaram, senior policy manager for Medicaid and the uninsured at KFF. .
Beyond the upcoming Republican trifecta, the ongoing legal battle over the rule also offers a potential path to overturning it.
Defeat of this bill would mean a victory for the nursing home industry. The facility has argued with Republican lawmakers, along with some Democrats, that the rule sets impossible and expensive standards for facilities to meet and will ultimately lead to worse care for residents. They are calling for the rules to be repealed. And it will cause the store to close.
Instead, nursing home industry groups such as the American Health Care Association and the National Center for Assisted Living (ACHA/NCAL) are calling for “targeted investments” to grow the long-term care workforce.
According to the association, one of the strategies proposed to attract more caregivers to the profession is to provide current and prospective caregivers with financial assistance as well as training and educational opportunities. is to provide. Group website.
In an email to The Hill, a spokesperson for AHCA/NCAL said, “Nursing facilities will struggle to find qualified caregivers and will be forced to limit admissions, downsize, or close entirely.” I wrote it.
This organization was one of two industry associations: filed a lawsuit An attempt was made to block the rule earlier this year.
Currently, less than 20 percent of the nation's nursing homes meet all three of the rule's minimum staffing requirements, according to the report. Analysis from KFF. Most of the facilities that do not meet these requirements are for-profit nursing homes and nursing care facilities.
According to the analysis, 11 percent of for-profit facilities are able to meet minimum staffing requirements, compared to 41 percent of nonprofit facilities and 39 percent of government facilities.
AHCA/NCAL estimates that the nursing home industry will need to hire approximately 100,000 additional nurses and nursing assistants to ensure that all facilities meet all three requirements of the rule. . The group says adding staff will cost $6.5 billion a year.
Meanwhile, the federal government estimates that the cost of implementing the final rule will be: $43 billion Over 10 years.
But no matter how costly or “illogical” opponents of the rule believe it to be, labor unionconsumer advocates and public health experts argue, will ultimately help improve the health and safety of nursing home residents and staff.
“We have minimum staffing standards for dog day care centers, and we have minimum staffing standards for day care centers,” says the National Consumer Voice for Quality Long-Term Care Public. Policy Director Sam Brooks said. “It's foolish to think this is a burden that will destroy the industry.”
Brooks told The Hill the rule is aimed at raising the standards of care in the nation's worst-performing nursing homes and is not a “one-size-fits-all” mandate.
One of the 2024 studies It was found that nursing home residents were less likely to be hospitalized or visit emergency departments in facilities with more certified nurses. another 2024 survey Research from the University of California, San Francisco shows that nursing homes with more certified nursing assistants receive better quality of care for their residents.
Sherry Culp, long-term care ombudsman for the Kentucky Cabinet for Health and Family Services, reiterated the importance of nursing and long-term care facility staffing at 20 nursing home resident forums she and her colleagues have hosted across the state. Recall what was emphasized.
“Every forum talked about staffing issues and the negative impact of staffing shortages,” Culp said. She added that she had recently received reports of rapidly declining nursing home residents being completely neglected due to lack of staffing.
The resident was discovered to be debilitated when family visited and found him with multiple trays of untouched food around his bed, urine in his shoes, and unable to speak. It is said that he did.
“If we have enough staff, someone will come to see if this person is able to eat, if they need assistance going to the bathroom, or if they need a change of clothes. Wouldn't you like to do that?”
Experts, advocates, and labor unions are fighting to keep this rule from being overturned. In a joint letter to Congressional leadership last week, they urged lawmakers to oppose any legislation or year-end agreement that would “derail or postpone” it.
“Industry opposition has little meaning when many facilities already meet or exceed certain elements of the staffing rules and the total ratio of the rules is below the current national average,” the letter reads. It's dark.
“There is virtually universal agreement that facilities should employ registered nurses 24 hours a day. Essentially, this is a rule designed to address the nation's worst-performing homes. .”
