In case you missed it,
Senator Kevin Cramer (R-ND) delivered a floor speech before the U.S. Senate on Tuesday, addressing the impacts of the Centers for Medicare & Medicaid Services’ (CMS) federal staffing mandate on communities across the country. Senator Cramer warned that North Dakota nursing homes are “feeling the squeeze” because of lack of workforce: only 25 percent of his home state’s facilities meet the 24/7 on-site RN requirement included in the staffing mandate and only 14 percent of rural facilities. In his remarks, Senator Cramer criticized CMS for its disregard for the negative impact on seniors and veterans, particularly those in rural and underserved communities, by implementing overbearing rules:
“To meet these elevated staffing levels, our facilities really have no good options, if they have any options at all. At existing staffing levels, North Dakota facilities would need to reduce the average number of residents served per day by about 74 people to satisfy this mandate. […] In my state, we’ve had six facilities close since 2021, indicating the already challenging operating environment. I fear this misguided rule will supercharge this trend and deprive rural individuals the opportunity to receive care in their own communities, near the people they love and know the best: their families, and their friends, their loved ones.”
Outside of North Dakota, nursing homes across the country are facing unprecedented labor shortages that are leading to widespread closures and concerns about access to care for America’s seniors. Maine has been one of the hardest-hit states, where more than a dozen nursing homes have closed since 2020. As the Lewiston Sun Journal recently
reported, nursing homes are experiencing shortages in all jobs, from nurses to maintenance staff.
Angela Westhoff, CEO of the Maine Health Care Association, said:
“It’s the worst crisis we have seen in long-term care going back decades … There just aren’t enough workers in Maine to meet all staffing needs. Access to skilled nursing is challenged now. As Maine continues to age, it’s only going to get worse.”
Nursing home closures in the Pine Tree State limit access to care for vulnerable seniors and negatively impact the entire health care system. The Lewiston Sun Journal continues:
“With the closure of 15 skilled nursing facilities since 2020, the number of nursing home beds in Maine is down 600 to 6,002, the [Maine Health Care] association reported. In the same period, 16 residential care facilities have closed or converted to another level of care, reducing the number of assisted-living beds by 360 to 4,546, according to the association and the Muskie School of Public Service.
“As a result of the closures, on any given day in Maine, about 200 hospital patients are waiting for a bed in long-term care, whether they need skilled nursing after heart or hip surgery or another form of residential care.”
On the other side of the country, Idaho is grappling with the same challenges. Robert Vande Merwe, the executive director of the Idaho Health Care Association, published an op-ed in the Idaho State Journal sounding the alarm on how the Biden Administration’s one-size-fits-all federal staffing mandate will only lead to more closures:
“Things may get worse for Idaho nursing facilities before they get better. The Centers for Medicare & Medicaid Services (CMS) is proposing a rule that would require nursing facilities to have registered nurses (RNs) on staff 24 hours a day. While this might sound like a good idea, the truth is Idaho doesn’t have enough nurses to make it happen. Most facilities have an RN on one shift and LPNs when an RN is not clinically necessary.
“If the CMS rule goes into effect, the options will be grim for many Idaho facilities. Either pay sky-high rates for traveling nurses, which Medicaid won’t fully cover, or close their doors for good.
“At the Idaho Health Care Association, we support the idea of better patient care, but this rule isn’t possible without major changes. We need to ensure our nursing facilities have enough staff to provide the care that Idahoans deserve. That’s going to require action from the state and federal government, Idaho’s education institutions, and private healthcare establishments.”
Thousands of seniors and their families have increasingly fewer options when it comes to long term care, and the federal staffing mandate will only exacerbate this crisis. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) found that nursing homes will need to hire 102,000 additional nurses and nurse aides to meet the requirements put forth by CMS. If facilities cannot hire the number of workers they need, nearly one-quarter of nursing home residents (more than 290,000 individuals) will be at risk for displacement when facilities are inevitably forced to further reduce their census or close their doors altogether.
Nursing homes need supportive programs and policies that help nursing homes attract and retain critical staff to the field. Last week, the U.S. House Committee on Energy and Commerce advanced two bills and a joint resolution that will help strengthen the long term care workforce, which included the Congressional Review Act (H.J.Res.139) to overturn the staffing mandate. Lawmakers should build on this momentum and pass real solutions that will protect seniors’ access to quality care.
Read the full op-ed by Idaho Health Care Association Executive Director Robert Vande Merwe HERE.
Read the full story in the Lewiston Sun Journal HERE.
Watch Senator Cramer’s full floor speech HERE.