A lawsuit filed Tuesday by 20 states challenging a federal rule mandating increased staffing levels for nursing homes claims it will force facilities to close.
Those states are led by Republican attorneys general, including Indiana's Todd Rokita. 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, registered 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 included staffing evaluation requirements, rather than minimum staffing hours, and went into effect on August 8th. Minimum staffing hours will take effect in May 2027, as detailed in . KFF analysisAs a result, 19% of facilities were found to 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. The organization continued 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.
Complaints regarding temporary staffing
In Indiana, the Nursing Home Association is advocating for expanding the state's current nurse training pipeline. Expand certification for foreign-educated nurses. One in five Hoosiers will be at or above retirement age by 2030. This is the time when people begin to experience health problems that require care. Currently, entire medical facilities are struggling to attract such specialists, who are in short supply.
Indiana's core nursing home lobbying groups, the Indiana Health Care Association and Leading Age Indiana, are not named as parties to the lawsuit, but IHCA has previously raised concerns about the impact the mandate would have on its members. It was stated.
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 only lowered the price to
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