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Behind-the-Scenes Advocacy for Long-Term Care Staffing Minimum

Introduction: In the realm of long-term care (LTC), a crucial staffing minimum has encountered delays, leaving providers waiting anxiously while advocates work tirelessly behind the scenes. With the Office of Management and Budget (OMB) scrutinizing the rule, the sector’s top proponents are making their presence felt in the nation’s capital, aiming to mitigate any potential adverse effects. This blog delves into the ongoing efforts and discussions surrounding the long-awaited Minimum Staffing Standards for Long-Term Care Facilities rule.

Behind-the-Scenes Advocacy for Long-Term Care Staffing Minimum

Advocacy Efforts in the Nation’s Capital: While providers on the ground have little choice but to wait for the overdue staffing minimum, advocates have taken center stage in Washington, D.C. The OMB, responsible for reviewing regulatory measures, has been under scrutiny since commencing its review process on May 30. Among the 25 rules from the Department Health and Human Services currently under review, the proposed Minimum Staffing Standards for Long-Term Care Facilities rule has attracted significant attention from the LTC community.

Sector representatives, such as LeadingAge and the American Health Care Association (AHCA), have actively engaged with OMB staff and other stakeholders involved in shaping the final version of the rule. These meetings serve as preemptive advocacy, enabling private groups to provide crucial information to the government regarding the potential impact of the proposed or final rule. While OMB listened to concerns without providing immediate feedback, these discussions offered advocates an opportunity to highlight their commitment to delivering high-quality care and raise important considerations.

AHCA’s Collaborative Efforts: The AHCA, in particular, has been working closely with White House and Congressional officials to address concerns and streamline the process. CEO and President Mark Parkinson and other AHCA leaders met with OMB on June 14, demonstrating their commitment to finding a balance between policy and practicality. AHCA believes that a purely enforcement-focused approach will not solve the labor crisis in the long-term care sector. Instead, they hope that the Centers for Medicare & Medicaid Services (CMS) will develop a supportive approach that focuses on increasing the workforce while maintaining access to care for seniors.

Advocacy in Congress: AHCA has also been actively engaging with members of Congress who oppose the staffing minimum. These lawmakers are exerting pressure on OMB while the bill remains under review. Senator Jon Tester, for instance, voiced concerns about the potential impact of a one-size-fits-all staffing mandate on rural facilities. He emphasized the importance of tailoring solutions to address workforce challenges in underserved areas, urging CMS to provide flexibility to nursing homes facing recruitment and retention obstacles. Such concerns have been echoed by AHCA and other stakeholders, highlighting the need for a nuanced approach that takes into account the unique circumstances of different care settings.

The Call for Proactive Measures: Mark Parkinson, in an op-ed published in The Hill, stressed the counterproductive nature of a one-size-fits-all regulation. He highlighted the ongoing workforce challenges faced by skilled nursing facilities, exacerbated by the loss of 250,000 workers during the pandemic. Parkinson argued that to truly address the labor crisis, proactive measures supporting workforce recruitment and retention are needed. AHCA’s commissioned study further revealed that implementing a 4.1-hour per patient per day staffing standard would necessitate a substantial increase in nurses and aides, as well as significant financial investments.

Behind-the-Scenes Advocacy for Long-Term Care Staffing Minimum

Conclusion: As the long-awaited staffing minimum for long-term care facilities remains under review, advocates are intensifying their efforts behind the scenes. Engaging with OMB, White House officials, and members of Congress, these advocates strive to ensure that any proposed rule considers the unique challenges faced by the sector. While concerns about the impact of a one-size-fits-all approach persist, there is a growing call for proactive measures that address the workforce crisis and support the recruitment and retention of caregivers. The future of long-term care staffing standards hangs in the balance, with advocates working diligently to achieve a balance between regulation and the practical realities of delivering quality care.



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