The Administration’s prioritization of courting votes over common sense has become evident, particularly in light of the growing concern in Congress that a staffing mandate could jeopardize the entire healthcare system. The unpublished 329-page rule can be accessed on the Federal Register site, with a projected final publication date of May 10, 2024. The new regulations are slated to take effect on June 21.


Thanks to the feedback provided during the public comment period, members of Congress from both sides of the aisle continue to oppose the mandate. 


“This is a big country. We should make sure that our policies reflect the fact that the different regions of the country have different approaches. The rural and, in fact, remote parts of America have different needs, and I would hope that we would listen to the folks most in need.” - Representative Adrian Smith (NE-03)

Thankfully, some are fighting back. On March 6, 2024, the House Ways & Means Committee passed the Protecting America’s Seniors’ Access to Care Act. This act aims to block the implementation and enforcement of the nursing home staffing mandate proposed by the Biden Administration. If enacted, the mandate will lead to nursing home closures and waiting lists for seniors and vulnerable Americans, impacting nearly 300,000 nursing home residents1—particularly in rural and underserved communities—and denying them access to care.

Direct Supply Senior Living Advocacy, the American Health Care Association, and the National Center for Assisted Living spearheaded efforts to voice supplier, provider, and family concerns during the critical public comment period which ended on November 6, 2023. Over 1,000 groups—including nonprofits, faith-based organizations, and state and national nursing home associations—united to oppose the mandate.2 They shared workforce challenges with CMS and advanced solutions that would alleviate staffing shortages. CMS received nearly 47,000 comments on their minimum staffing proposal.3

When the Centers for Medicare & Medicaid Services (CMS) originally proposed4 these comprehensive skilled nursing staffing requirements on September 1, 2023, their own research found that these unfunded requirements had no basis5 and would cost providers at least $7 billion each year.6

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