WASHINGTON – On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule which mandated new minimum staffing standards for long-term care (LTC) facilities in order to provide “safe and high-quality care for the over 1.2 million residents receiving care in Medicare and Medicaid-certified LTC facilities each day.” According to estimations published by CMS, this proposed rule would force approximately 75% of nursing homes to increase the number of staff within their facilities.

Under the proposed rule, nursing homes across the country would be required to significantly boost staff in order to meet the requirements posed by CMS. In rural states already facing staffing shortages, including North Dakota, this new standard would make the requirement nearly impossible to meet.

U.S. Senators Kevin Cramer (R-ND) and Angus King (I-ME), members of the Senate Veterans’ Affairs Committee, introduced a piece of legislation which would require the U.S. Department of Veterans Affairs (VA) to conduct a study examining the risks associated with the proposed rule issued by CMS. This follows the letter Senators Cramer and King sent to CMS Administrator Chiquita Brooks-LaSure asking the agency to withhold from establishing staffing mandates for long-term care facilities and instead work with Congress on flexible, commonsense solutions.

“Senator King and I are simply asking the VA to conduct a study to prove what we already know: this misguided proposal will negatively impact veterans access to long-term care services,” said Senator Cramer. “Every state and community are different, and setting an unrealistic, national standard for all nursing homes and facilities serving veterans will further inflame existing staffing shortages and deprive veterans of the long-term care options they earned.”

“It is one thing to create a policy that looks good on paper, but it is quite another to examine the effects that policy has on the day-to-day lives of Maine veterans,” said Senator King. “While the CMS rule aims to improve the quality of long-term care for veterans by increasing staffing requirements, this one-size-fits-most policy could cause facilities in rural areas to shut down. This bill will allow us to take a closer look at the impact that the proposed CMS rule would have on VA and VA affiliated nursing homes so we can best protect access to long-term care options for veterans in Maine.”

Specifically, this legislation would require the Secretary of the VA to submit a report regarding the proposed rule’s impact on the access of veterans to LTC facilities, no later than 60 days after the date of the bill’s enactment. The study will be required to include:

  • The number of state homes where current staffing could not meet the minimum staffing threshold outlined by CMS and the number of veterans who reside in these homes.
  • The number of community nursing homes currently contracted with the Department of Veterans Affairs that would not meet the threshold for minimum staffing and the number of veterans who reside in them.
  • An assessment of whether or not such proposed rule would have any impact on community living centers of the Department.
  • Analysis of whether the Department will be able to adequately meet the long-term care needs of veterans after the full implementation of the proposed rule.

Click here for bill text.