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Action Alert: Please Submit Letters to CMS on its Proposed Minimum Staffing Rule

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  • Action Alert: Please Submit Letters to CMS on its Proposed Minimum Staffing Rule
October 6, 2023

In less than one month, over 4,000 letters have been sent by concerned providers from across the country to CMS registering their concerns about its proposed federal “one size fits all” minimum staffing rule.  To date, just 40 of the letters opposing the federal minimum staffing requirements have come from Massachusetts.  MSCA has determined that over 85% of nursing facilities in Massachusetts would not meet one of the 3 proposed HPRD requirements, and the consequences of implementing this rule in its current form are dire.  We strongly urge you to please take action now and ask your staff to participate in this letter writing campaign to CMS to request changes to the agency’s proposed rule.

To assist with crafting and submitting comments, the American Health Care Association (AHCA) has released an issue brief summarizing key talking points, and set up a link to comment on the proposed rule on its website. All comments are due to CMS no later than November 6, 2023.

While there are multiple injustices associated with the proposed rule, it is particularly egregious in its omission of Licensed Practical Nurses (LPNs). Excluding LPNs is a failure to account for almost two-thirds of our licensed nurses and blatantly disregards and devalues the essential care they provide to our residents. Massachusetts nursing facilities employ 9,000 LPNs and they deserve to be counted in CMS’ proposed hours per resident day for the compassionate, high-quality care they provide.

As drafted, key elements of the proposal include:

  • 2.45 hours per resident day (HPRD) of certified nursing assistants (CNAs) within 3 years;
  • 0.55 HPRD of RNs within 3 years;
  • 24 hour per day RN requirement within 2 years;
  • An enhanced facility staffing assessment which would apply independently of the proposed HPRD requirements.
  • No funding to cover the projected $175 million in new costs facilities in Massachusetts alone would incur to implement and comply with the rule, assuming there was even staff available given the current historic workforce shortage.

This massive chaos is directly attributable to two colossal failures in CMS’ proposed rule:

  1. Failure to acknowledge and respect the invaluable work of our 9,000 Licensed Practical Nurses (LPNs) by excluding these essential caregivers in the proposed 3.0 hours per resident day (HPRD) requirement; and
  2. Failure to fund the compensation necessary to hire, train and upskill the 3,000 individuals necessary to meet the proposed rule. The total annual cost in the Commonwealth alone is projected to be over $175 million. 

Please click here to join the letter writing campaign.

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