Central ND News

The Center for Medicare and Medicaid Services (CMS) finalized a rule last month, mandating minimum staffing levels at long-term care (LTC) facilities participating in the Medicare and Medicaid programs, including community facilities serving veterans. U.S. Senators Kevin Cramer (R-ND) and Angus King (I-ME), members of the Senate Veterans’ Affairs Committee (SVAC), have expressed concerns regarding the potential negative effects of this rule on access to LTC services, particularly for veterans and seniors in rural areas.

In a letter to Secretary Denis McDonough, the senators requested that the Department of Veterans Affairs (VA) produce a report on the impact of the CMS rule. The senators had previously introduced bipartisan legislation requiring the VA to assess risks posed by this rule to elderly veterans. This bill mandates an evaluation of the VA’s ability to meet LTC needs at VA and VA-affiliated nursing homes, especially in rural areas if the rule is implemented as proposed. The legislation requires that findings be reported to Congress within 60 days of becoming law.

The finalized staffing rule heightens concerns about its potential impact on veterans. “We write to express concerns about the potential harmful impact on veterans resulting from the recently finalized Centers for Medicare and Medicaid Services (CMS) rule, entitled ‘Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting’ (RIN: 0938-AV25),” wrote Senators Cramer and King. They emphasized that “our healthcare system is grappling with a severe shortage of qualified nurses and caregivers,” exacerbated by challenges from the COVID-19 pandemic.

They noted that long-term care facilities across Maine, North Dakota, and other states are struggling post-pandemic. Without sufficient staff to fill required positions, many facilities face imminent closure. The senators called for a VA report to understand better how this new CMS rule would affect veterans nationwide.

“Simply put – we are concerned long-term care facilities, including those serving veterans, may not be able to meet the new staffing requirements,” they continued. Highlighting that less than one in five nursing facilities nationwide currently meet all prescribed staffing requirements, they pointed out ongoing hiring struggles within the industry. A recent survey indicated that 89% of nursing homes are actively trying to hire Registered Nurses but face obstacles due to lack of interest or qualified candidates.

The senators concluded by stressing their shared goal: “We all want our veterans, older adults, and disabled populations served by long-term care facilities to have adequate staffing.” They raised serious concerns about whether these goals can be realistically met given current conditions in LTC facilities nationwide.

Senator Cramer has previously raised alarms over this rule's broad impact on LTC facility operations for aging veterans. In October 2023, both senators addressed these issues in a letter to CMS Administrator Chiquita Brooks-LaSure.

For further details on their letter, click here.

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