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A federal nursing home minimum staffing mandate “sounds like a good idea, but in practice, it is not,” American Health Care Association / National Center for Assisted Living President and CEO Mark Parkinson told President Biden in a letter Tuesday. 

The White House Office of Management and Budget on May 30 began a review of a rule drafted by the Centers for Medicare & Medicaid Services.

Mandated staffing minimums will lead to nursing home closures, according to Parkinson, who noted that more than 500 nursing homes already have shuttered their doors since 2022, “often due to an inability to find workers.”

“Nursing homes that primarily care for residents on Medicaid won’t have the resources to recruit staff or pay for this mandate,” Parkinson wrote. “Those facilities, as well as those who they serve and employ, will be hurt the most.”

Home- and community-based service providers cannot step in for skilled nursing care, Parkinson told the president. Such providers include home care agencies and some assisted living communities.

“Not only do nursing home residents require around-the-clock clinical care, but HCBS programs are not equipped to care for this influx of displaced seniors,” he wrote. HCBS providers, the CEO added, also are experiencing staffing challenges and have not been able to keep up with demand.

“Instead of a mandate, we need to implement 21st Century solutions to this 21st Century problem. Those include changing our immigration policies to attract thousands of international nurses, using innovative technology to help provide better care with fewer people, and continuing our efforts to help seniors stay at home as long as possible,” Parkinson said.

Meanwhile, the Service Employees International Union, AFL-CIO and the National Consumer Voice for Quality Long-Term Care are planning to host a virtual rally today at 2 p.m., Eastern time, in support of the Biden administration’s proposed rule on staffing in nursing homes.

“Despite COVID-19’s devastating and disparate effects on nursing home residents and workers, thousands of facilities remain understaffed, which lowers the quality of care that residents receive and breeds poor working conditions and high rates of injury for staff members,” the organizations wrote in a press release. “The nursing home industry is increasing its efforts to block a federal mandate on staffing even as it does little to improve investment in the care workforce and creating safe work environments.”