U.S. Senators Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, and Ron Wyden (D-OR), Chairman of the U.S. Senate Committee on Finance, have written a letter to Center for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. The Senators are urging the agency to finalize and implement a new rule proposed by the Biden Administration to address the nation’s nursing home staffing crisis.
The new rule instructs CMS to establish minimum staffing requirements for nursing homes, a measure the Senators have long advocated as crucial to ensuring safety and quality care for nursing home residents.
In their letter, the Senators stated, “Our nation’s 1.2 million nursing home residents deserve high-quality care that prioritizes their safety. The proposed rule takes a vital step towards ensuring residents receive this high-quality care by establishing commonsense staffing minimums and improving enforcement…We urge CMS to provide for strong enforcement of a final staffing standard while ensuring state survey agencies and their staffs are adequately resourced to conduct this important work.”
Senator Casey has dedicated his career to enhancing the safety of nursing homes for residents. In February, he urged the Biden Administration to enforce minimum staffing standards in nursing homes and praised the announcement of the new rule in September. In May, Senator Casey released a report highlighting a crisis in nursing home oversight due to severe staffing shortages at state survey agencies.
Casey and Wyden previously introduced the Nursing Home Improvement and Accountability Act, which would mandate nursing homes to meet minimum staffing standards, ensure a registered nurse is available 24 hours a day, require a full-time infection control and prevention specialist, and provide additional resources through Medicaid to support these care and staffing improvements and raise wages.
Key points from the letter include:
- Urging CMS to strengthen and finalize the Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule.
- Highlighting studies that show a link between staffing levels and quality of care in nursing homes, particularly during a COVID-19 outbreak.
- Noting a joint investigation by the Senate Committee on Finance and the Senate Special Committee on Aging into the impacts of understaffing at nursing homes on emergency preparedness.
- Stressing the importance of high-quality care for nursing home residents, and how this proposed rule can ensure it through enforcement of commonsense staffing minimums.
- Pointing out that while the proposed rule includes 0.55 hours per resident day (HPRD) for Registered Nurses (RNs) and 2.45 HPRD for Nurse Aides (NAs), it does not include an HPRD for Licensed Practical Nurses (LPNs). The Senators urge CMS to consider including LPNs in the final rule.
- Supporting the proposed rule’s requirement for 24/7 RN staffing to protect resident safety.
- Advocating for flexibilities in the final rule that reflects differences in workforce availability, facility size, and resident demographics.
The letter from Senators Casey and Wyden signals a significant step towards addressing the nursing home staffing crisis. By urging CMS to finalize and implement the new rule, the Senators are championing the rights and safety of nursing home residents across the nation.
Read the full letter here.
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