'Wave of the bureaucratic wand' won't fix nursing home staffing: States to CMS

Fifteen governors sent a letter Nov. 1 to CMS asking the agency to reconsider increased staffing hour requirements for nursing homes.

"On Sept. 1 … CMS proposed new regulations for long-term care facilities that impose unnecessary, one-size-fits-all staff requirements," the letter said. "If adopted, CMS's proposed regulations will force many long-term care facilities in our communities to close, eroding access to healthcare for some of our most vulnerable citizens."

The letter cited the current shortage of registered nurses, who "have never been scarcer," as a concern, and said the proposed requirements ignore the "critical roles" of licensed practical nurses and other caregivers in long-term care facilities.

A 2022 CMS study also does not support the proposal, according to the letter. The study found there is "no obvious plateau at which quality and safety are maximized or 'cliff' below which quality and safety steeply decline."

States are also concerned that proposed regulations would significantly increase costs and decrease access to care. The letter said the CMS estimated complying with the rules will cost $4 billion annually, and independent analysts estimated it would cost $6.8 billion annually.

"Your proposed rule treats this complex, deep-rooted problem as something to be solved with a simple wave of the bureaucratic wand," the letter said. "This is not only unrealistic, but it also threatens to unravel the work we have done, while harming the seniors, elderly, and disabled it's designed to help."

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

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