Nursing home advocacy groups and congressional insiders are actively discussing the potential reversal of President Biden’s nursing home staffing rule. This move, reported by Axios, is being explored as a strategic budgetary measure to fund a year-end healthcare deal.
Budgetary Implications
The Congressional Budget Office (CBO) provided a cost estimate in late June that has become a central point in these discussions. Reversing the staffing rule could save $22 billion over ten years, a sum that could fund various healthcare initiatives. These initiatives might include extending telehealth flexibilities, implementing Pharmacy Benefits Management (PBM) changes, and addressing Medicare hospital outpatient costs.
Political Maneuvering
The potential savings from reversing the staffing rule could make it an attractive option for lawmakers facing opposition from PBM and hospital industries. According to Axios, if these industries render certain policies unviable, lawmakers might seek politically expedient alternatives, such as overturning the staffing rule.
Industry Opposition
The nursing home industry has expressed strong opposition to the staffing mandate. Industry groups have filed a lawsuit against the rule, arguing it imposes unrealistic and costly requirements. Clif Porter, VP of Government Relations at the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), has warned of severe consequences for senior care access if the mandate persists.
“We urge members of Congress to take action. We support the passage of bipartisan and bicameral legislation in Congress that will overturn this impossible mandate, as well as finding alternative, meaningful solutions to improve the workforce crisis,” Porter told Skilled Nursing News in an emailed statement.
Legislative Efforts
Porter highlighted two pieces of legislation aimed at blocking the mandate: The Protecting America’s Seniors’ Access to Care Act and a Congressional Review Act resolution. These legislative efforts reflect bipartisan concern over the feasibility and impact of the staffing rule.
Staffing Rule Details
The staffing rule mandates a total nurse staffing standard of 3.48 hours per resident day (HPRD). This includes at least 0.55 HPRD of registered nurse (RN) care and 2.45 HPRD of direct nurse aide care. The remaining 0.48 HPRD can be fulfilled by any combination of nurse staff, including RNs, licensed practical nurses (LPNs), or nurse aides. Additionally, the rule requires an RN to be onsite 24 hours a day, seven days a week.
Conclusion
As discussions continue on Capitol Hill, the outcome of these deliberations remains uncertain. The nursing home industry, backed by certain congressional members, is pushing for reversing the staffing rule, citing its impracticality and potential negative impact on senior care. The ongoing debate underscores the complexity of balancing regulatory mandates with budgetary constraints and healthcare priorities.
By staying informed and engaged with these discussions, stakeholders can better understand the potential changes and their implications for the Capitol Hill nursing home community and beyond.
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