Nebraska, Iowa and 13 other states pen letter against federal nursing home staffing proposal

LINCOLN — Fifteen Republican governors, led by Nebraska’s Jim Pillen of Nebraska and Iowa’s Kim Reynolds, are adding on to criticism of a proposed federal nursing home staffing rule.

The U.S. Centers for Medicare & Medicaid Services proposed the new rule Sept. 1 to ensure that long-term care residents receive a minimum number of daily nursing hours. Registered nurses would be required to be available 24 hours a day, seven days a week. The rule would also expand resident assessment requirements.

In a Wednesday letter to President Joe Biden, the governors said they are “pulling multiple levels” to ensure facilities have the needed staff to care for residents.

“In contrast, your proposed rule treats this complex, deep-rooted problem as something to be solved with a simple wave of the bureaucratic wand,” the governors wrote.

“This is not only unrealistic, but it also threatens to unravel the work we have done, while harming the seniors, elderly and disabled it’s designed to help,” the letter continues. “We urge you to reconsider your commitment to unfunded mandates and instead enter into a genuine state-federal dialogue on how best to serve residents of long-term care facilities in our states.”

The governors add that the rule would most impact rural communities, further exacerbate the country’s workforce crisis, which has not recovered from COVID-19, and erode access to care “for some of our most vulnerable citizens.”

Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services, previously described the rule as an “important first step” to hold nursing homes accountable and ensure residents get the “safe, high-quality care that they deserve.”

Wednesday’s letter echoes similar pushback in September from Nebraska’s congressional delegation and organizations including the Nebraska Nursing Facility Association, Nebraska Assisted Living Association and Nebraska Health Care Association.

The Center for Medicare Advocacy also criticized the rule as insufficient and “a major step backwards.”

In addition to Pillen and Reynolds, governors from the following states joined the letter: Georgia, Indiana, Mississippi, Missouri, Montana, Nevada, New Hampshire, Oklahoma, South Carolina, South Dakota, Tennessee, Texas and Wyoming. The Centers for Medicare & Medicaid Services will accept comments on the proposed rule through Nov. 6.