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October 19, 2023

Senators Ask CMS to Withhold Burdensome Staffing Mandate, Need Permanent Workforce Solutions to Support Veterans

WASHINGTON, D.C. — U.S. Senators Kevin Cramer (R-ND) and Angus King (I-Maine), members of the Senate Veterans Affairs Committee (SVAC), are fighting to keep many VA facilities open nationwide, by asking the Centers for Medicare and Medicaid Services (CMS) to find workable solutions for staffing shortages at long-term care facilities across the country. VA and long-term care facilities serve retired veterans and future demand is expected to grow.

In a letter to CMS Administrator Chiquita Brooks-Lasure, the senators ask CMS to withhold from establishing staffing mandates for long-term care facilities and instead work with Congress on flexible, commonsense solutions. Strict federal staffing proposals would be detrimental to many VA facilities across the country that would be unable to meet the minimum staffing requirements to remain open.

The CMS rule being considered would establish minimum staffing requirements for long-term care facilities as part of the Biden-Harris Administration's Nursing Home Reform initiative. According to the latest polling, 80% of nursing facilities across the country would be unable to meet the minimum requirements to remain open if the rule is enacted.

“We write today to express concern over the Centers for Medicare and Medicaid Services’ (CMS) proposed rule, entitled ‘Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting’ (RIN: 0938-AV25), particularly as it relates to veterans’ access to long-term care. The Rand Corporation estimated 80 percent of the nation's 18 million military veterans will have some need for long-term services.  Should this proposed rule move forward, it is imperative that the regulations placed on facilities do not inadvertently lessen aging veterans’ options for care. We recognize the importance of high-quality service, but as drafted and without revisions, this proposal may have unintended consequences that will close nursing homes,” the senators wrote.

“Fundamentally, we must address the pipeline of health care workers moving into the industry. The potential of prolonged staffing shortages across the healthcare sector must be taken into account. A recent article published by KFF that examined the impact of CMS’ proposed rule found that, “… among all nursing facilities, fewer than 1 in 5 could currently meet the required number of hours for registered nurses and nurse aides.” Given the broad impact of CMS’ proposed rule for facilities across the country, we are concerned the policy will further inhibit veterans’ access to long-term care services if the workforce dynamics aren’t drastically improved by the proposed implementation dates,” the senators continued.

“As rural facilities in our states struggle to stay afloat, we were disappointed to see the agency’s failure to provide sufficient weight to the care provided by Licensed Practical Nurses (LPNs) and other key staff. Nursing facilities across our states employ a substantial number of LPNs and rely on these professionals to support our veterans and seniors alike. The decision to discount LPN staffing as part of any staffing minimum requirement appears misguided. We urge the department to reconsider this approach and instead look for a way in which we can promote greater collaboration among all clinical staff for the benefit of facility residents,” they concluded.

Earlier this year, the senators took part in SVAC hearing where they questioned Jonathan Blum from the Centers for Medicare and Medicaid Services about this push for minimum standards across the VA even if it results in the closing of facilities.

Click here to read the letter.



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