A lawsuit filed Tuesday by 20 states, including Utah, challenges federal rules mandating increased nursing home staffing levels, arguing that facilities will be forced to close.
Each state is led by a Republican attorney general, including Utah's Sean Reyes. Named defendants also include leaders of the federal Department of Health and Human Services and the Centers for Medicare and Medicaid Services.
“While the nursing home industry certainly has its challenges, it fills an important need in our community that cannot be replaced,” the 66-page application states. “Instead of addressing the legitimate challenges facing nursing homes, Defendants have issued heavy-handed mandates…This final rule is designed to strengthen the nursing home industry, as many struggling nursing homes will be forced to go out of business. It poses an existential crisis.”
Biden administration announces new rules for nursing home staffing
The new requirements from the Health and Human Services Agency would set national standards for nursing home staffing. This comes in the wake of COVID-19, which has put a spotlight on the institutional environment. Due to the congregate nature of long-term care facilities and the overall poor health of their residents, these facilities have experienced high infection and death rates during the pandemic, as well as low staffing levels. It could have gotten worse.
This focus has led regulatory agencies to increase staffing levels to better respond to health and safety concerns from residents. Many residents continue to report problems related to inadequate staffing.
Most nursing homes in the country will not meet the rules finalized in April. The rules include requirements that a registered nurse be present 24 hours a day, 365 days a year, that residents receive at least 0.55 hours of care from a registered nurse each day, and that residents receive 2.45 hours of care. Daily care provided by a nursing assistant.
Currently, certified nurses are only required to work at a facility seven days a week, eight consecutive hours per day.
States would also need to collect additional information on employee compensation.
Difficult to introduce in nursing care facilities
Nurses and other health care professionals have been slow to return to the workforce in long-term care, which has recovered the most from losses caused by COVID-19, and the nursing home lobbying industry fiercely opposes the proposed rule. . Meanwhile, some families and residents say the rules don't go far enough.
The first phase of the rule, which included staffing evaluation requirements rather than minimum staffing hours, went into effect on August 8th. As detailed in KFF's analysis, minimum staffing hours will take effect in May 2027. % of facilities will meet the new standards.
Tuesday's lawsuit claimed that an outside review found nursing homes would need to hire more than 100,000 full-time employees at a cost of about $6.8 billion annually. It went on to say that 94% of these long-term care facilities do not meet at least one of the three requirements, putting the care of hundreds of thousands of residents at risk.
The state attorneys general, who were joined by lobbying groups as plaintiffs, argued that the federal agency overstepped its authority to create new rules, adding that previous staffing standards were set by Congress.
Specific losses to states include rising nursing home costs, but Medicare and many private insurance companies do not cover such care or only cover it to a limited extent. The state and federal governments pay primarily through Medicaid. CMS estimates that Indiana facility costs could increase by $10.9 million if a registered nurse is required to be on-site 24/7, or as much as $151.2 million if all regulations are followed. It may cost.
Tuesday's lawsuit also questions whether stricter staffing standards, rather than the more flexible current rules, would improve the care provided to residents, calling it a “one-size-fits-all approach.” There is.
“The problem is that the[CMS staffing minimum]study ignores the ongoing “national medical staff shortage'' and “current employment challenges'' that are barriers for nursing homes. “This would make compliance with new federal staffing requirements impractical,” the complaint states.
The group points to “barrier exemptions” set up by CMS that allow facilities to circumvent the requirement, saying the bar is too high for facilities to meet and that it has changed the requirement for registered nurses from 24 hours a day to 16 hours a day. He said that he had simply lowered the amount.
Plaintiffs in this case include Iowa, Nebraska, Kansas, South Carolina, Alabama, Alaska, Arkansas, Florida, Georgia, Idaho, Indiana, Kentucky, Missouri, Montana, Oklahoma, North Dakota, South Dakota, Utah, Virginia, and West Virginia. state.
Co-plaintiffs include Leading Age Lobbying and professional associations in Iowa, Nebraska, South Dakota, Kansas, Oklahoma, South Carolina, Missouri, New Jersey, Ohio, Colorado, Delaware, Virginia, Maryland, Pennsylvania, Tennessee and Michigan. Included.
Defendants CMS and the U.S. Department of Health and Human Services have not yet filed a response to the lawsuit. In other similar lawsuits, including one brought by industry players in Texas, authorities have denied wrongdoing.
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