John O'Connor illustration
McKnight’s Editorial Director John O’Connor
John O'Connor
John O’Connor

In times of uncertainty, it helps to get answers from those at the top.

And these days, few things are causing more provider angst than the federal government’s newly hatched plan to implement minimum staffing requirements for nursing homes. 

So imagine the anticipation that crackled in the air as industry operators converged for a LeadingAge session on Tuesday, where the esteemed speaker was none other than Evan Shulman. He just happens to direct the nursing homes division at the Centers for Medicare & Medicaid Services.

Shulman, widely acknowledged as a sharp and amiable figure, did address many existing and pending regulatory issues facing operators today. But there wasn’t much he was able to share about when CMS will be taking its relationship with staffing mandates to the next level. 

He quickly made it clear that the controversial staffing rule was off the table. For many in attendance, it was akin to entering a renowned steakhouse only to discover that chicken or fish were the only menu choices.

Now in fairness to Shulman and CMS, the government has a lot to, er, digest. By Monday’s midnight deadline, the feds had received somewhere in the neighborhood of 50,000 replies to its staffing proposal. Every single one of those comments will need to be read. 

That being noted, it’s probably safe to assume most of the correspondence directed regulators to take one of three steps:

1) Implement the proposed mandates,

2) Don’t implement the proposed mandates or

3) Give this a little more thought before doing anything rash.

And as LeadingAge President and CEO Katie Smith Sloan and others have noted, even though the proposed rule applies directly only to nursing homes, there’s no doubt that it would affect senior living providers and others along the long-term care continuum. As Sloan told McKnight’s editors this week, providers all are “fishing from the same pool” of workers.

For what it’s worth, Shulman’s LeadingAge session did address an array of other important regulatory topics.

He highlighted CMS’ renewed emphasis on the survey process, infection control practices in the post-public health emergency era, and the agency’s campaign to make the long-term care field more attractive to potential job candidates. Antipsychotic drug use and more equitable application of civil monetary penalties also received a shout out.

Shulman welcomed questions and engaged with attendees, promising to take their concerns about access to care, especially in rural settings, back to his colleagues.

All those matters matter. But as for the meatiest matter of them all? Let’s just say we probably won’t be seeing steak on the menu any time soon.

John O’Connor is editorial director for McKnight’s Senior Living and its sister media brands, McKnight’s Long-Term Care News, which focuses on skilled nursing, and McKnight’s Home Care. Read more of his columns here.