CMS Minimum Staffing Standards Proposed Rule Talking Points from National

LeadingAge has provided members with initial talking points on the CMS Minimum Staffing Standards Proposed Rule. Use these when having conversations with your state and federal delegates. LeadingAge Kansas has started compiling data and talking points specific to our membership to utilize during the comment period of the rule which runs through November 6. Stay tuned for further updates.

Talking Points
CMS Minimum Staffing Standards Proposed Rule
September 5, 2023

• Ensuring America’s older adults and families can receive quality nursing home care is a shared goal. For the first time in decades, our federal government is committed to meaningful action to ensure America’s older adults and families can receive quality nursing home care. LeadingAge and our nonprofit, mission-driven nursing homes share the Administration’s goal.
• Nursing homes are not all the same. Many nonprofit and mission-driven nursing homes, including LeadingAge members, are rooted in faith traditions that have long played a special and critical role in communities nationwide.  We are mission-minded, values-driven organizations; our leaders and staff often have deep ties to the communities in which we deliver care and services. Our organizations have stood the test of time—sometimes for over 100 years as key pillars of our cities and towns.
• The cost of implementation will cripple nursing homes. The costs of delivering quality care already far exceed reimbursement, and this unfunded mandate will only make it harder for nonprofit and mission-driven nursing homes to continue to serve older adults and families.
  The Abt study acknowledges that “additional staffing costs, estimated in the billions, could be a parallel barrier to implementation.” CMS’ proposal estimates the cost of meeting these ratios over 10 years will be $40.6 billion with an average annual cost of $4.06 billion. How can the Administration expect nursing homes to absorb costs of that magnitude?
• There are simply no people to hire. There is no issue more pressing for nursing homes than the workforce crisis. Leading Age’s most recent member workforce snap poll found that 92% of nursing home respondents still report significant or severe workforce shortages. In an economy with 1.6 open jobs for every 1 available job seeker, it is meaningless to mandate staffing levels that simply cannot be met.
• Mandated staffing requirements from CMS will decrease access to access care and services. Current workforce and financial challenges are already limiting access to care. Providers are strained and operating under severe workforce shortages. Adding impossible staffing mandates will only make accessing care more difficult for older Americans and families as providers will have to limit admissions or – at worst – cease operations.
• Funding goes hand in hand with quality care, yet our country’s highly fragmented, patchwork approach to financing the caregiving services and other supports older Americans and families need to age well, is not up to the job. Medicaid, the dominant payer of long-term care services, doesn’t fully cover nursing homes’ cost of quality care. Regulations and enforcement, even with the best intentions, just can’t change that math. 
• Federal action on staffing mandates must be realistic to achieve its intended effect. Any action must consider the critical issues of available current and prospective staff as well as the cost of delivering quality nursing home care far exceeds reimbursement.