Biden Pledges Better Nursing Home Care, But He Likely Won’t Fast-Track It

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

This is the title of a KHN News article published on March 3, 2022.

“President Joe Biden’s top Medicare official suggested Wednesday that forthcoming rules to bolster nursing home staffing won’t be issued under a mechanism, known as interim final rules, that would allow regulations to take effect more or less immediately.

But Brooks-LaSure suggested the administration’s sought-after nursing home changes are not considered urgent even as nursing homes and other long-term care facilities register shocking numbers of covid deaths. A KFF analysis estimated that more than 200,000 residents and staff members of long-term care facilities had died from covid as of Jan. 30, amounting to at least 23% of all U.S. deaths.

“When we do interim final rules, those tend to be things that are absolute emergencies,” Brooks-LaSure said when asked whether they would be considered for nursing home staffing levels, “or tight timelines.” 

The White House this week said CMS will first study the issue and then propose minimum staffing standards “within one year,” but officials have been otherwise vague about timing. When issuing regulations, federal agencies generally release a proposal and then seek public feedback before finalizing it. The entire process can take months or even years. But there’s an exception that allows newly issued regulations to kick in much faster even if the agency allows for public comment — a move that Biden officials have exercised recently when issuing a covid vaccine mandate for health workers and implementing a ban on surprise medical bills that took effect this year.

Biden’s proposal would amount to the biggest increase in federal nursing home regulation in nearly four decades. CMS could pursue several elements under the agency’s existing authority, such as investigating the role of private equity in the sector, increasing its scrutiny of the poorest-performing facilities, and making public more information about facilities’ finances and operators. 

Some ideas would require congressional action. They include allowing CMS to ban from the Medicare and Medicaid programs those facilities owned by people or corporations with subpar track records and to increase penalties on poor-performing facilities from $21,000 to $1 million.

Most states have standards for nursing home staffing levels, but the minimums vary widely. Some states have been criticized for granting exemptions so facilities can provide less care for each resident.”

The quality-of-care issues are not solely found in the U.S. This article speaks to and links to information on an international basis.

I encourage you to review the entire article as well as share it with your team and colleagues.

[NOTE: The article includes references to the Statement from CMS Administrator Chiquita Brooks-LaSure on President Biden’s State of the Union.]