By Paula Span in the NYT
Ed note: We should be proud of our LTC Washington State Ombudsman, Patricia Hunter, for advocating for us and pushing back on the negative moves of CMS.
Month after month, Patricia Hunter and other members of the Nursing Home Reform Coalition logged onto video calls with Congressional representatives, seeking their support for a proposed federal rule setting minimum staff levels for nursing homes.
Finally, after decades of advocacy, the Biden administration in 2023 tackled the problem of perennial understaffing of long-term care facilities. Officials backed a Medicare regulation that would mandate at least 3.48 hours of care from nurses and aides per resident, per day, and would require a registered nurse on site 24 hours a day, seven days a week.
The mandated hours were lower than supporters had hoped for, said Ms. Hunter, who directs Washington State’s long-term care ombudsman program. But “I’m a pragmatic person, so I thought, this is a good start,” she said. “It would be helpful, for enforcement, to have a federal law.”
In 2024, when the Centers for Medicare and Medicaid Services adopted the standards, advocates celebrated. But industry lawsuits soon blocked most provisions of the rule, with two federal district courts finding that Medicare had exceeded its regulatory authority.
And after the 2024 elections, Ms. Hunter said, “I was concerned about the changing of the guard.” Her concerns proved well-founded.
In July, as part of the Trump administration’s budget reconciliation bill, Congress prohibited Medicare from implementing the new staffing standards before 2034. Last month, C.M.S. repealed the standards altogether. They never took effect.
“It was devastating,” said Ms. Hunter.
As with environmental law and consumer protections, the Trump administration’s enthusiasm for deregulation has undone long-sought rules to improve care for the aged. And it has introduced a Medicare experiment for prior authorizations, now getting underway in six states, that has alarmed advocates, congressional Democrats and a good number of older Americans.
Taken together, the moves will affect many of the facilities and workers who provide care, and introduce complications in health coverage in several states.
On the nursing home front, “it’s clear C.M.S. has no interest in ensuring adequate staffing,” said Sam Brooks, director of public policy for the National Consumer Voice for Quality Long-Term Care.
“They’re repealing a regulation that could have saved 13,000 lives a year,” he added, citing an analysis by University of Pennsylvania researchers.
Industry groups argued that nursing homes, with high rates of staff turnover, were already struggling to fill vacancies. (continued on Page 2 or here)