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Opposing the CMS Minimum Staffing Rule: What Has Been Done to Date?

June 24, 2024

In April, the Centers for Medicare and Medicaid Services (CMS) issued the minimum staffing mandate for skilled nursing facilities. From the start, we engaged our members from across the country to raise our voice and the visibility of the impact of this ruling with the administration and other key policy makers including:

  • Conducting targeted stakeholder meetings, secured based on the breadth and impact of our network in the senior services space and existing advocacy relationships, including with:
    • CMS Administrator Chiquita Brooks-LaSure and her staff, to ensure our members concerns were heard specific to the proposed rule.
    • Key senators and their staff who lead or serve on committees with oversight of Medicaid issues to share our on-going concerns including Senate Committee on Health, Education, Labor and Pensions (HELP); and Senate Finance Committee, House Energy and Commerce, House Ways and Means, among others.
    • The White House Domestic Policy Council, which advises the President on domestic policy issues. And
    • the Office of Management and Budget during final rulemaking to share our concerns.
  • Activating our network in a letter-writing campaigns to Congress and CMS with over 200 messages sent to key policymakers from across the country.
  • Submitting comments on the proposed rule to ensure the challenges associated with implementation were clearly articulated.

Our collective advocacy had an impact in shaping the final rule—with longer phase-in periods in rural and underserved communities, and hardship exemptions.  At the same time, these small wins are wholly insufficient given the inadequacy of Medicaid reimbursement rates and the ongoing crisis in the direct care workforce. This rule will accelerate nursing home closures in underserved and rural communities and make it harder to provide quality access to care for older adults across the country.

Read Our Strategy to Build on our Work Opposing This Rule

United, we will continue to take action together as one of the largest faith-based provider networks; we have the reach, we have the expertise and we have the responsibility.

Sarah Dobson is Senior Director of Public Policy and Advocacy at Lutheran Services in America.