Sen. Deb Fischer (R-NE) officially introduced a bill late Tuesday aiming to block the Centers for Medicare & Medicaid Services from implementing its proposed nursing home staffing mandate.
The widely anticipated Protecting Rural Seniors Access to Care Act, S. 3410, had been held up for weeks as Fischer sought bipartisan co-sponsors. At introduction, Sens. Roger Marshall (R-KS.), James Lankford (R-OK), Jon Tester (D-MT), Kyrsten Sinema (I-AZ), Joe Manchin (D-WV), Roger Wicker (R-MS), Susan Collins (R-ME), and Angus King (I-ME) had signed on.
“Nursing homes across the country face historic staffing shortages, and nowhere are those challenges more real than in rural states like Nebraska. This mandate from the Centers for Medicare and Medicaid Services would force many facilities to reduce their number of patients or even close their doors for good. My legislation will stop this staffing rule and allow time to find a fairer solution that protects rural facilities across our state,” Fischer said.
Fischer’s bill mirrors one introduced in the House in late September by Rep. Michelle Fischbach (R-MN). H.R. 5796 would prohibit federal officials from finalizing the draft rule introduced on Sept. 1 and convene a nursing home workforce advisory panel instead.
The House bill had 17 co-sponsors, all Republicans, as of Nov. 28 and has been referred to the Committee on Energy and Commerce, and the Committee on Ways and Means.
Katie Smith Sloan, president and CEO of LeadingAge, applauded the bill’s introduction and said it could help meet a shared goal of ensuring “access to quality care in nursing homes.”
“The CMS proposed nursing home staffing requirement is the wrong approach,” Sloan said. “By prohibiting this unrealistic and unfunded mandate, the Protecting Rural Seniors’ Access to Care Act will help to ensure older adults can get the care and services they need and also fend off more nursing home closures. It further offers a path to much-needed solutions by establishing a panel to address workforce shortages that are chronic throughout the sector.”
In his own press release, co-sponsor and frequent mandate critic Tester said the rule could result in “mass facility closures across Montana.”
“I’ve told the Biden Administration from the jump that imposing a burdensome one-size-fits-all staffing mandate simply won’t work for Montana’s rural nursing homes,” he said. “Our long-term care facilities are already facing severe workforce shortage issues, and this federal staffing mandate could force facilities to shut their doors. My bipartisan bill will stop this rule dead in its tracks, and I’m committed to working with my colleagues to address the nursing home workforce so we don’t leave rural seniors in the lurch.”
In September, Tester led a letter signed by 28 senators demanding the Biden Administration and CMS abandon a rule they had proposed just weeks before.
The rule, coming after more than a year’s wait, would require nursing homes to provide 0.55 hours of direct RN care per patient day and 2.45 hours of nurse aid care. While the rule would go into effect in three years after being finalized, it gives an extra two years for rural facilities to get up to speed on the overall hourly rate. Rural facilities would have an extra year to meet the proposal for 24/7 RN coverage while all other nursing homes would have just two years after the rule is finalized to meet this requirement.
The proposal drew nearly 47,000 formal comments, each of which requires analysis by CMS. Observers have said that will slow any final proposal from being issued, with some predicting any implementation is at least a year away.
