CMS’s pending minimum staffing requirement proposal is expected in early May 2023. It is critical that providers across the country take action now to share the provider perspective on how this rule will create new challenges for providers without offering any meaningful solutions to the ongoing LTC workforce shortage.

On Friday, February 24, WHCA/WiCAL submitted a public comment to CMS, sharing concerns with CMS’s intention to issue a minimum staffing rule.

See WHCA/WiCAL’s comment letter here.

In the comment letter, CEO Rick Abrams stressed that a minimum staffing requirement would not magically fix the long-term care staffing shortage, and would have counterproductive consequences by imposing new penalties for facilities who are trying to find staff but cannot:

Our members are already doing everything they can to recruit and retain staff. Unfortunately, a staffing mandate simply will not work for Wisconsin because the workers are simply not there. National jobs reports, most recently the Bureau of Labor Statistics, show that nursing homes have lost more than 210,000 workers since the start of the pandemic and despite every effort to hire more staff, we are making little progress. An arbitrary minimum staffing standard will not make people magically appear. If nursing homes face fines or penalties for failing to meet an unreasonable staffing mandate, facilities will close and residents and families in Wisconsin will suffer.

SNF MEMBERS: PLEASE SUBMIT YOUR OWN COMMENT BY FEBRUARY 28

The minimum staffing rule will be drafted and mostly finalized by sometime in March, and so we ask members to submit a comment to CMS with concerns on the implications of a rigid minimum staffing requirement by the end of February. WHCA/WiCAL requests Wisconsin nursing home providers to submit a comment sharing their perspective on the proposed rule.

The more personalized you can make your comment, the better. Use your own circumstances and your own examples to drive home your message. Keep the focus on the beneficiaries: your patients and residents. As Gov. Parkinson emphasizes in the webinar presentation (link below), providers are not expected to submit a long treatise, but should focus on telling their story and explaining how the minimum staffing rule would have negative consequences for your facility, even if that is done in a few paragraphs.

Providers can submit a comment today. Visit AHCA’s advocacy center, where you will find clear instructions for creating and submitting a public comment to CMS on the pending nursing home minimum staffing requirement.

Consider this outline for your own personalized comment to CMS:

1. Explain Who You Are

1. 1. What you do and how long you have been in this line of work
   2. Why you work in long term care
   3. Describe your building: Location, Number of units, Profile of your residents
2. Tell Them About Your Commitment to Quality

1. 1. Mention any AHCA Quality Award or other award you have received
   2. Explain what your residents mean to you and your team

3. Workers Are Not Out There

1. 1. A. Explain how hard is to get workers and your challenges to get them
      1. Give any story or example of not being able to get staff
   2. Tell them how many positions you have open, inability to fill shifts, hire new recruits
   3. Discuss your use of agency staff and related costs
   4. Tell them that a staffing mandate will not create workers

4. Asks: Given these ongoing challenges as we still deal with, and try to recover from, the COVID-19 pandemic, encourage CMS to proceed in a thoughtful and deliberate manner and to consider the following recommendations:

1. Reconsider your plan, and do not implement a minimum staffing requirement. If you do it, then phase it in and only when the workforce is back
2. Any requirement must be paid for completely by Medicaid & Medicare

INSTRUCTIONAL WEBINAR AVAILABLE

AHCA/NCAL hosted a webinar on Friday, January 20 to discuss the importance of – and to provide tips for –  contacting CMS to weigh in on proposals the agency is currently writing for SNF minimum staffing requirements. Presenters included AHCA/NCAL President and CEO Mark Parkinson and Senior Director of Grassroots Program Matthew Smyth.

For a recording of an AHCA webinar on submitting a comment, go to https://educate.ahcancal.org/products/contact-cms-minimum-staffing-requirements-for-skilled-nursing-facilities?force_login=1 and log in using your AHCA/NCAL username and password.

A copy of the slides is available here.

Please reach out to Jim Stoa at jstoa@whcawical.org with any questions.