Fifteen Republican governors, led by Jim Pillen of Nebraska and Kim Reynolds of Iowa, are amplifying their disapproval of the proposed nursing home staffing mandate inn a letter addressed to President Joe Biden on Wednesday.
The governors emphasized their own efforts to guarantee that facilities are adequately staffed for resident care, adding that the staffing mandate undercuts those and ignores regional variations of the labor shortage.
The governors argued that the rule would disproportionately affect rural communities, exacerbate the ongoing workforce crisis in the country, which has not fully recovered from the impact of Covid-19, and diminish access to care for some of the most vulnerable citizens.
They urged the president to reconsider the imposition of unfunded mandates and instead engage in a genuine state and federal dialogue to determine the most effective means of serving long-term care facility residents in their respective states.
“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,” they wrote. “We urge you to reconsider your commitment to unfunded mandates and instead enter into a genuine state-federal dialogue on how best to serve residents of long-term care facilities in our states.”
CMS’s proposed regulations would require a minimum of 0.55 hours per resident per day (HRPD) provided by registered nurses (RNs) and 2.45 HRPD provided by certified nurse aides (CNAs). Long-term care facilities would also be required to have an RN onsite 24 hours a day, seven days a week.
“These staffing mandates would be imposed nationwide on all Medicare and Medicaid-certified facilities, with no regard to the unique needs of facilities and the communities they serve,” they wrote.
In addition to Pillen and Reynolds, governors from the following states have joined in signing the letter: Georgia, Indiana, Mississippi, Missouri, Montana, Nevada, New Hampshire, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, and Wyoming.
The proposed rule remains open for public comments until November 6, according to the Centers for Medicare & Medicaid Services.
The letter echoes sentiments from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), which penned a letter in October in which AHCA/NCAL President and CEO Mark Parkinson said meaningful change will happen through collaboration and innovation, rather than the mandate’s “unrealistic requirement and enforcement.”
