House Ways and Means Committee passes bill blocking proposed CMS nursing home minimal staffing rule

Nurse and older man

Key Takeaways

On March 5, the U.S. House of Representatives Committee on Ways and Means marked up and reported out of committee the Protect America’s Senior’s Access to Care Act (H.R. 7513). If signed into law, this legislation would block the Center for Medicare and Medicaid (CMS)’s ability to finalize a rule establishing minimum staffing levels for skilled nursing facilities. 

CMS minimum staffing standards rule 

In September 2023, CMS issued a proposed rule that would impose minimum staffing standards on facilities that participate in Medicaid or Medicare. Key highlights of the proposed rule include:  

  • Requires long-term care facilities to have an average daily nurse staffing level equivalent to at least 0.55 hours per resident, or one registered nurse for every 44 residents 
  • Requires 2.45 nurse aide hours per resident per day, or approximately one aide for every 10 residents
  • Requires at least one registered nurse to be on site 24 hours a day, seven days a week  
  • Does not include new funding for additional staff but sites recent workforce incentive initiatives under HHS 
  • Includes a “hardship exemption” which exempts the facility from punitive assessments for up to 1 year

Explore NACo's Blog on the Proposed Rule

What is NACo doing?

NACo supports the passage of H.R. 7513 and vocally opposes CMS’s finalization of the proposed rule on nursing home staffing minimums without further modification. In November, NACo submitted a letter to the U.S. Department of Health and Human Services (HHS) and CMS advocating county-owned and operated long-term care facilities and requesting significant changes to the proposed rule.

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