Medicaid Matters Weekly is a blog series aimed to be a trusted source for timely updates, insights and expert guidance on the ever-changing landscape of Medicaid, with a special focus on long-term care. Each week we’ll highlight critical developments, how they impact your clients, and offer practical tips to keep your planning strategies sharp and your clients protected.
Nursing Home Staffing Mandates Struck Down
A federal judge in Texas has struck down two key provisions of the Biden-era nursing home staffing rule—a 24/7 RN requirement and a minimum of 3.48 hours of nursing care per resident per day (including 0.55 hours of RN care). The court determined that the Centers for Medicare and Medicaid Services (“CMS”) exceeded its authority by enforcing rigid staffing standards regardless of facility-specific needs. Supporters of the mandate had pointed to its potential to save 13,000 lives annually, while the majority of nursing homes – especially for-profit facilities – were unable to meet these thresholds.
Shortly after the ruling, the House Energy and Commerce Committee proposed in its budget reconciliation blueprint a moratorium on the staffing mandate through 2035, alongside a freeze on provider taxes – a major revenue source used by states to boost Medicaid reimbursement rates. Still, experts in the long-term care industry warn that deep Medicaid cuts (targeting $715–880 billion over the next 10 years) could destabilize the long-term care system by undermining wages, staffing, and ultimately, access to services.
Implications for Medicaid Planning & Skilled Nursing Recipients
Without federal minimum standards and amid the not-yet-passed funding cuts, nursing homes may vary widely in staffing, potentially affecting care quality. Families must be more vigilant when touring facilities, to assess facility staff metrics during placement.
Further, there may be fewer care options for those in need. Loss of provider tax funding could lead to facility closures – especially in rural or underfunded regions – raising wait times or forcing long-distance placements, away from family and loved ones.
In a crisis, families are not always able to thoroughly research a facility before applying. The last-minute scramble to secure a Medicaid bed may become the norm, with less staffing, fewer Medicaid beds, and increased need for care with the aging Baby Boomer generation.
LWP Practice Tip: Consider developing a list of nursing homes with capable and sufficient staff, strong staffing records and stable Medicaid funding. Share this with clients and discharge planners to ensure the best placement possible for your clients. Saving the family the time and stress of finding a facility is something simple you can do to help the client’s families in a time of crisis. Further, working directly with those facilities may lead to referrals and synergistic relationships for you.
As always, stay alert to the frequently-changing federal budget negotiations around Medicaid funding, provider taxes, and staffing mandates, because Medicaid Matters.
