Action Alert on Medicaid Advocacy 2025
LeadingAge has written an action alert on the need to protect Medicaid from cuts and programmatic changes that would limit access to Medicaid coverage and services. Congress is actively discussing moving forward with budget reconciliation early in 2025 and as part of this process, Medicaid cuts are on the table for inclusion, so LeadingAge is asking that members express their support for the Medicaid program through the alert found here.
Congress Sends Letter to Dr. Oz Regarding Medicare Advantage and Conflicts of Interest
On December 10, Senators Warren (D-MA), Wyden (D-OR), Blumenthal (D-CT), Durbin (D-IL), Merkley (D-OR), and Cardin (D-MD) along with Rep Lloyd Doggett (D-TX) sent a letter to CMS Administrator Designate Dr. Mehmet Oz regarding his previous statements on Medicare Advantage vs. Traditional Medicare. The letter highlights Dr. Oz’s previous statements on wanting “Medicare Advantage for All” and calling traditional Medicare “highly dysfunctional.” They ask a number of questions about Dr. Oz’s investments including significant stock holdings in United Healthcare. The letter can be found here.
LeadingAge Calls on CMS to Remedy Duplicative Reporting
In a December 4 letter, LeadingAge once again called on the Centers for Medicare & Medicaid Services (CMS) to resolve the outstanding issue of duplicative resident COVID vaccination status reporting. This letter is a follow-up to May and September requests to address reporting issues. Read the December letter here.
2025 Congressional Calendars
House and Senate leadership have shared their respective calendars for 2025. The 2025 Senate calendar was posted by the incoming Senate Majority Leader John Thune (R-SD) on X and can be found here. The 2025 House calendar was posted by House Majority Leader Steve Scalise (R-LA) and can be found here. Eager to advance their agenda, Republican leadership in both chambers have more in-session DC workdays planned for 2025 than the current session of Congress does for 2024. “Get ready to work,” Senator Thune said on X.
Senate Introduces Bill to Expand Health Care Apprenticeships
On December 6, Senator Wyden(D-OR), Chair of the Senate Committee on Finance introduced the Fast Track Apprenticeship Act which aims to streamline the development of new apprenticeship programs in healthcare and update and accelerate federal and state labor agencies’ healthcare apprenticeship application processes to reduce delays and red tape for current and future programs. The bill would do so by requiring federal and state labor agencies to make determinations on health care apprenticeship applications within 45 days of receipt and requiring that the Department of Labor (DOL) digitize apprenticeship agreement forms, modernize the application process, and enhance accessibility for applicants.
The bill also would provide employers the opportunity to revise and resubmit applications after rejection without enduring prolonged delays. By modernizing and expediting the review process, the bill facilitates easier pathways for employers to train aspiring health care professionals. This legislation is important for LeadingAge members because it reduces barriers to entry for healthcare workforce training through the apprenticeship program which is a bipartisan workforce program that healthcare is often not well represented in. We look forward to supporting this and other changes to the apprenticeship program that would allow more of our members to take advantage of this pathway for future staff recruitment.
Hearing Proceedings Begin Concerning Marijuana Rescheduling
Formal hearing proceedings regarding the Drug Enforcement Administration’s (DEA) proposed rescheduling of marijuana began on December 2. This first convening served as a procedural day to address legal and logistical issues, including for presiding Administrative Law Judge John Mulrooney to ask questions of the organizations and individuals DEA has selected and designated as hearing participants. Shortly after, on December 4, Judge Mulrooney issued a pre-hearing ruling that sets a schedule, running from January 1 to March 6, for when participants will present information and testimony in the hearing. DEA will be the first to present, then other witnesses will follow, starting with organizations supporting the proposed rescheduling and followed by organizations opposed. Once the hearing concludes, the ALJ will submit its findings to the DEA, which DEA will consider, along with public comments submitted during the rulemaking and other information, to make a final determination about whether and how to finalize the proposed rule.
KFF Examines Nursing Facility Characteristics Data
On December 6, KFF released A Look at Nursing Facility Characteristics Between 2015 and 2024 with data from Nursing Home Compare and CASPER (Certification and Survey Provider Enhanced Reports). The topline findings of the analysis include:
- The number of CMS certified nursing homes dropped by 5% between July 2015 and July 2024 (the study period).
- The number of certified nursing homes and the number of nursing home residents is lower now than it was in 2015.
- During the same period, the average daily nursing care hours per resident day decreased by 8% (from 4.13 hours to 3.80), despite residents’ health needs generally rising and the average number of deficiencies per facility increased.
- The decline in staffing hours was primarily caused by a 21% reduction in registered nurse (RN) hours and an 8% decrease in nurse-aid hours. In contrast, licensed practical nurse (LPN) hours rose by 6% during the same period. The only year that did not see a decrease in hours per resident day was 2021 which is likely due to a larger reduction in the number of residents due to COVID than the reduction in staff in that year.
- Both the average number of deficiencies and the proportion of facilities with serious deficiencies have risen over time, potentially due to increased oversight and reduced staffing levels. From 2015 to 2024, the average number of deficiencies grew from 6.8 to 9.5, a 40% increase. The share of facilities reporting serious deficiencies between this period rose from 17% to 28%. This rise was generally consistent, with the exception of a stable period between 2020 and 2022.
- KFF also reported that the share of facilities by ownership type and the share of residents with Medicaid as their primary payment, 6 out of 10 residents, was stable over time. It was noted that the for-profit facilities have received increased scrutiny.
This analysis points to the need for a large investment in nursing home staff which LeadingAge has called for repeatedly called for adequate funding to prevent nursing home closures and ensure adequate staffing.
