The provided text appears to be a webpage from the law firm Crowell & Moring's blog, specifically their Health Law section. The content includes:

1. A list of recent updates and articles on various topics related to health care law, such as the attorney-client privilege waiver, information blocking, False Claims Act cases, and more.
2. A sidebar with links to different categories and archives of past posts, including topics like administrative law, advertising, antitrust, artificial intelligence, COVID-19, and more.
3. Information about the Crowell & Moring health care practice, including their experience in areas such as health care antitrust, managed care, fraud and abuse, and privacy litigation.
4. A disclaimer and copyright notice at the bottom of the page.

The webpage is designed to provide readers with updates and insights on current developments in health care law, while also promoting Crowell & Moring's expertise and services in this area.

The Centers for Medicare & Medicaid Services (CMS) has proposed a 4.1% pay increase for nursing homes in fiscal year 2025, but declined to issue an update on its staffing minimum proposal as part of its annual payment rule proposal. The proposed increase includes a 2.8% market basket update and a 1.7% market basket forecast error adjustment, which is considered modest by industry leaders.

American Health Care Association President and CEO Mark Parkinson expressed disappointment with the proposed increase, stating that it will not be enough to offset the costs of meeting CMS's proposed staffing minimum requirement. Parkinson urged the Administration and CMS to reconsider the staffing mandate, warning that it could lead to nursing home closures and reduced access to long-term care for seniors.

The proposed rule also includes changes to the Patient-Driven Payment Model ICD-10 Code Mappings and Value-Based Purchasing updates. Additionally, CMS has proposed an expanded Civil Monetary Penalty process that would allow for more penalties to be imposed on nursing homes for health and safety violations. The agency is seeking comments on potential future updates to the non-therapy ancillary component of PDPM.

Industry leaders are cautiously optimistic about the proposed pay increase, which they believe will help offset increased labor costs associated with staffing shortages. ADVION Executive Vice President Cynthia Morton stated that the payment update reflects the increased costs experienced by providers over the past couple of years and will greatly help with recruiting and retaining staff.

The 211-page proposed rule is set to be officially published in the Federal Register, followed by a 60-day comment period. A final rule is expected to be announced by the end of July.

This text appears to be a report from the Kaiser Family Foundation (KFF) analyzing the impact of new federal requirements for nursing facility staffing. Here are the main points:

Background: The Centers for Medicare and Medicaid Services (CMS) has finalized a rule requiring nursing facilities to have a minimum number of staff on duty at all times.

Key findings:

• In 45 states, fewer than half of nursing facilities have enough staff to meet the new requirements.
• About 1 in 5 nursing facilities would meet fully-implemented minimum staffing standards in the final rule with current staffing levels.
• Rural facilities are more likely to not meet the requirements compared to urban facilities.

Methodology: The analysis uses data from Nursing Home Compare, a publicly available dataset that provides information on quality of care and key characteristics for approximately 14,900 Medicare and/or Medicaid-certified nursing facilities. The analysis drops about 3% of nursing facilities due to missing data.

Limitations: The analysis does not look at facilities that meet the requirement to have an RN on staff 24 hours a day, seven days a week (24/7) due to limitations in publicly available data.

Implications: The report highlights concerns about the potential unintended consequences of the new requirements, including increased costs for nursing facilities and the potential impact on state budgets and federal spending. The need for nursing facility care is expected to increase as the population ages, which may intensify these challenges.

Overall, the report suggests that many nursing facilities face significant challenges in meeting the new staffing requirements, particularly rural facilities.

A recent analysis by USA Today has found that nearly all nursing homes in the US fail to meet the minimum staffing requirements set forth by the Centers for Medicare & Medicaid Services (CMS). The analysis, which used payroll-based journal data from last August, showed that only 160 out of 14,500 skilled nursing facilities met the new requirements during the summer quarter of 2023. Furthermore, most nursing homes met the requirements on only three days out of a total of 92.

The CMS rule requires nursing homes to have a minimum of 3.48 hours per resident per day (HPRD) of total staffing, with specific allocations for registered nurses (RN) and nurse aides. However, according to the analysis, about 50% of federally funded facilities were able to provide at least 0.55 hours of care from an RN daily, while facilities were only able to provide each resident with 2.45 hours of care from a CNA on one day per week.

The gap in meeting staffing requirements was found to be significantly wider in many Southern states, with Louisiana, Oklahoma, and Texas performing the worst. In contrast, states such as Alaska, Hawaii, Utah, Maine, and Delaware fared better in meeting the total minimum staffing standard. The article notes that rural counties have five years to implement the minimum staffing standards, while urban areas are allowed up to three years.

The findings of this analysis highlight a significant challenge facing nursing homes across the US, particularly those in Southern states. The CMS rule is intended to ensure that residents receive adequate care and attention from qualified staff, but it appears that many facilities have a long way to go in terms of meeting these requirements.