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The American Hospital Association (AHA) has sent letters to Senate and House members urging them to support legislation that would prevent the enforcement of minimum staffing requirements for long-term care facilities set by the Centers for Medicare & Medicaid Services (CMS). The AHA expressed concerns that these requirements would stifle innovation in care delivery, lead nursing homes to reduce capacity or close, and exacerbate shortages of nurses and skilled healthcare workers.

The CMS rule requires 24/7 RN staffing and sets minimum staffing ratios for long-term care facilities. The AHA argues that this could lead to delays in urgent medical care as patients wait for nursing home placements, occupying hospital emergency departments and inpatient beds. Additionally, the AHA notes that implementing these requirements would be difficult for many nursing homes, with CMS estimating that 79% of long-term care (LTC) facilities would need to increase staffing to meet the proposed standards.

The AHA is supporting legislation that would prevent enforcement of this rule, citing concerns about its impact on patient care and the healthcare workforce. The organization has been vocal in its opposition to the CMS rule, arguing that it could have unintended consequences for patients and providers alike. By urging lawmakers to support legislation blocking the rule, the AHA hopes to prevent these potential negative outcomes.

The issue of staffing ratios in long-term care facilities is a contentious one, with some advocates arguing that minimum requirements are necessary to ensure adequate patient care, while others argue that such mandates could have unintended consequences for providers and patients. The AHA's efforts to block enforcement of the CMS rule reflect its concerns about the potential impact on healthcare delivery and workforce shortages.

It remains to be seen how lawmakers will respond to the AHA's appeals, but the organization's vocal opposition to the CMS rule has helped bring attention to the issue of staffing ratios in long-term care facilities. As debates over healthcare policy continue, the AHA is likely to remain a key player in advocating for policies that promote high-quality patient care and support the healthcare workforce.

The US Supreme Court's recent decision to discard the Chevron doctrine, which had allowed federal agencies to interpret ambiguous statutes, has significant implications for the healthcare industry. The ruling is seen as a "game changer" that could weaken the authority of the Centers for Medicare & Medicaid Services (CMS) and other federal agencies. The American Health Care Association (AHCA) has welcomed the decision, saying it amplifies their concerns about government overreach in implementing sweeping staffing mandates.

The Chevron doctrine had allowed CMS to interpret ambiguous statutes in a way that gave them significant power to regulate the healthcare industry. However, the Supreme Court's decision means that courts will now apply the Skidmore standard, which requires agencies to provide thorough reasoning and evidence to support their interpretations. This could limit CMS's ability to impose stringent regulations on healthcare providers.

The AHCA has been challenging a CMS rule that would require nursing homes to maintain minimum staffing levels. The organization argues that the rule is unworkable and would lead to significant financial burdens for nursing home operators. With the Chevron doctrine no longer in place, the AHCA may have a stronger case against the CMS rule.

Industry experts are predicting that the ruling could lead to "regulatory flux" in the healthcare industry, with agencies having to revisit their regulations and provide more evidence to support them. This could lead to some relief for nursing home operators who have been struggling to comply with overly stringent mandates.

However, it's worth noting that the ruling does not automatically mean that CMS will lose its case against the AHCA. The agency may still be able to provide sufficient evidence to support its rule, and the court may ultimately decide in its favor.

Overall, the Supreme Court's decision has significant implications for the healthcare industry, and nursing home operators are cautiously optimistic about the potential for relief from overly burdensome regulations.

The Centers for Medicare & Medicaid Services (CMS) has finalized a rule that imposes national minimum staffing requirements on nursing homes. The rule requires nursing homes to have at least one registered nurse on duty at all times, and also sets minimum staffing levels for certified nursing assistants and other caregivers. The new requirements aim to improve the quality of care provided in nursing homes and enhance resident safety.

The rule represents a significant change from previous regulations, which only required nursing homes to provide "sufficient" staff to meet residents' needs. CMS has announced that it will phase in the new staffing requirements over several years to give nursing homes time to adjust their staffing levels. The agency also plans to invest $75 million in a national campaign to recruit and retain nurses in nursing homes.

While the new rule sets a minimum standard for staffing, some states already have more stringent requirements. For example, New York and California require nursing homes to provide at least 3.56 hours of direct care per resident per day, which is higher than the federal requirement. Nursing homes that fail to comply with the new rule may face enforcement actions, including fines and termination of their Medicare or Medicaid provider agreement.

CMS has acknowledged that staffing shortages are a significant challenge for many nursing homes, particularly in rural areas. To address this issue, the agency plans to provide financial incentives to nurses who work in nursing homes and partner with states to support recruitment efforts. Some state regulators have also taken steps to relax enforcement of staffing requirements during times of acute labor supply shortages.

The new rule has significant implications for nursing homes and the residents they serve. While some critics argue that the rule may be overly prescriptive or burdensome, proponents argue that it is essential to ensuring that nursing home residents receive high-quality care from adequately trained staff.

The Centers for Medicare & Medicaid Services (CMS) has finalized minimum staffing requirements for nursing homes with the goal of ensuring safe and quality care in long-term care facilities. The final rule establishes a minimum of 3.48 hours per resident day (HPRD) of direct nursing care, with at least 0.55 HPRD provided by a registered nurse (RN) and 2.45 HPRD provided by a nurse aide.

Additionally, the final rule requires that at least one RN be onsite 24 hours a day, seven days a week, to provide skilled nursing care. The rule also establishes enhanced facility assessment requirements and staffing plans to maximize workforce recruitment and retention. Nursing homes will have varying timeframes to implement these requirements, with those in non-rural areas having two years to meet the 24/7 RN requirement and three years for other staffing requirements.

Nursing homes in rural areas will have more time to implement the requirements, with three years to meet the 24/7 RN requirement and five years for other staffing requirements. The final rule provides possible exemptions for qualified nursing home facilities based on workforce unavailability and other factors. The CMS received over 46,000 public comments on the proposed rule, which was issued in September.

The implementation timeframe for these requirements will begin on May 10, 2024, when the final rule is expected to be published. Nursing homes that fail to meet these minimum staffing requirements may face penalties and other consequences. The CMS aims to improve patient care and safety by establishing these minimum staffing standards.