Key congressional Republicans signaled opposition on Wednesday to a Centers for Medicare and Medicaid Services plan to impose staffing minimums on nursing homes..
Last month, CMS issued a proposed rule to mandate that skilled nursing facilities provide a minimum of three hours of nursing care per resident, per day, including at least 0.55 hours from registered nurses. The nursing home industry has long opposed staffing regulations, and may have found allies on Capitol Hill to help push back on CMS.
The American Health Care Association and other stakeholders have protested that, among other things, nursing homes are already suffering from a chronic staffing shortage and that the expense of additional hiring would be unsustainable.
During a hearing Wednesday, House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) expressed sympathy for the industry's point of view.
"I am concerned they are going to further undermine this workforce. This proposal would actively undermine access to care," McMorris Rodgers said.
Witnesses invited by Democrats were fulsome in their advocacy for the regulation as part of a solution to the staffing shortage.
"A strong federal minimum staffing standard is the best way to rectify the devastating and deadly consequences of this crisis," said Shelly Hughes, a certified nurse aide at facility in Bellingham, Washington. "CMS has proposed such a standard and it is imperative that we strengthen, implement and enforce this rule to the fullest extent."
Republicans also sounded off against a separate CMS proposal intended to boost pay for home health workers. In April, the agency published a proposed rule that would require states to devote at least 80% of Medicaid reimbursements for home- and community-based services to paying direct care professionals such as nurses and home health aides.
This regulation would create an unfunded mandate for states and burden home health companies, McMorris Rodgers and Health Subcommittee Chair Brett Guthrie (R-Ky.) said.
This aligned with testimony from nursing home industry representatives.
The so-called 80/20 rule "will not achieve the desired objective of increasing access to services or expanding the workforce," said Mary Killough, vice president of operations and government relations at AccentCare, a Dallas-based home health, personal care and hospice provider. "The likely outcome would be that home care providers will close."
Democrats offered support for CMS on both fronts.
"These proposed rules are strong first steps to help ensure that patients in nursing homes and home and community-based settings are able to get the care that they need," Energy and Commerce Committee ranking member Frank Pallone (D-N.J.) said. "But I understand that it may take some facilities more time than others to come into compliance."