Nursing Home Staffing Minimums Could Cause Medicaid Programs to Raise Rates

The Biden administration’s nursing home minimum staffing rule could have a major impact on states’ Medicaid programs, adding another layer of complexity to the highly anticipated and very controversial rule.

The nursing home minimum staffing rule is estimated to cost the residential care home industry up to $6.5 billion in additional payments each year, and mandates an additional 100,000 clinicians that the industry does not yet have, the American Health Care Association and National Center for Assisted Living say. Skilled Nursing News reports that the nursing home lobby said the requirements would put one-quarter of all residents at risk for displacement from their facilities.

From AHCA/NCAL President and CEO Mark Parkinson:

When nearly every nursing home in the country would be considered out of compliance and an exemption is basically impossible to obtain, it demonstrates how out of touch Washington bureaucrats are with reality. Nursing homes have been doing everything they can to recruit and retain more caregivers, but the available labor force is not there.

Nursing home corporations are having similar reactions to the rule. McKnights notes that Sabra Health Care executives ranted against the rule even as they were trumpeting 2023 successes in a first quarter earnings call last week. From CEO Rick Matros:

The rule is ludicrous on its face simply because the labor isn’t available. You can expect to see both legal and legislative action to overturn this.

According to Politico, state Medicaid programs are going to be on the hook to raise rates or risk nursing home closures when the rule takes effect. But the Centers for Medicare and Medicaid Services has maintained that the rule is paramount for nursing home quality concerns following the COVID-19 pandemic.

As far as legislative action is concerned, a new bill has been introduced to support nursing home staffing requirements. The bill, “Ensuring Seniors’ Access to Quality Care Act,” was recently amended to allow certified nursing assistant training operations to continue so long as fines are imposed for deficiencies unrelated to direct patient care, Skilled Nursing News reports.