The fight over a federal nursing home staffing mandate intensified Wednesday as a bipartisan group of U.S. senators launched an effort to kill the mandate, while two House Democrats and consumer advocates urged the Biden administration to stand behind it.
Sens. James Lankford (R-Okla.) and Joe Manchin (I-W.Va.) introduced a Congressional Review Act resolution of disapproval to overturn the administration's staffing mandate, finalized earlier this year, that will require most of the nation’s nearly 15,000 nursing homes to beef up staffing to comply with the regulation. Sen. Jon Tester (D-Mont.) and nearly 30 Republicans in the upper chamber backed the measure, saying the staffing ratios would be burdensome to skilled nursing facilities and might force many rural operators to shut their doors.
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The rule will require nursing homes to provide a minimum of 3.48 hours of care per resident, per day and have a registered nurse on staff 24 hours a day, seven days a week.
“Our seniors deserve high-quality care, not more D.C. mandates,” Langford said in a news release. “I am leading the fight to stop Biden’s one-size-fits-all requirements, which he knows will close rural nursing homes across Oklahoma.”
In a separate new release, Manchin called the staffing mandate “overly-demanding and unrealistic” at a time when nursing homes are already facing severe staffing shortages.
But just hours after the senators introduced the resolution, Reps. Lloyd Doggett (D-Texas) and Jan Schakowsky (D-Ill.) joined members of AARP, Service Employees International Union and the National Consumer Voice for Quality Long-Term Care at a Capitol Hill news conference, blasting the attempt to overturn the mandate.
“If they are successful there will be no action to save lives through these [tougher] standards,” Doggett said.
The Senate resolution comes less than a month after Reps. Michelle Fischbach (R-Minn.) and Greg Pence (R-Ind.) introduced a similar measure in the House. However, even if efforts to use the Congressional Review Act to block the mandate were to pass Congress, policy analysts expect they would be vetoed by President Joe Biden, as he has called for increased staffing in skilled nursing facilities.
The nursing home industry has ratcheted up its fight against the staffing regulation since the Centers for Medicare and Medicaid Services handed it down in late April.
Two nursing home trade groups, the American Health Care Association and the Texas Health Care Association, filed a lawsuit against CMS and the Health and Human Services Department in federal court last month, claiming they overstepped their authority in mandating minimum staffing in nursing homes.
The American Health Care Association and LeadingAge, a trade group representing nonprofit nursing homes, said in a joint news conference on Tuesday that some nursing homes have already started closing off wings to comply with the regulation, which will be rolled out over five years.
“The reality is that there is no scenario in which the staffing mandate works,” AHCA President and CEO Mark Parkinson said during the news conference. “Only 6% of nursing homes currently meet all four requirements. We know that 80% of nursing homes will have to hire more RNs to meet the 24/7 RN requirement, including 92% of rural facilities.”
Still, patient advocates on Capitol Hill Wednesday contend increased staffing in skilled nursing facilities is crucial to protect patients and said they will continue fighting for the regulation. AARP sent 200,000 emails to members of Congress urging them to cease any efforts to block the mandate, said Megan O’Reilly, AARP vice president of government affairs.
“It is shameful it is taking this long for a federal staffing standard,” O’Reilly said. “It is long overdue and it will help save lives.”
