STAFFING MANDATE

Nursing home staffing mandate rule widely expected to be trimmed if not revoked

Nursing home staffing mandate final arguments by the Department of Health and Human Services were made late Friday, January 17, 2025 in a federal lawsuit challenging its authority to impose a new nursing home staffing mandate.

The American Health Care Association, LeadingAge, and a group of Texas providers sued in May, seeking to throw out the rule on the grounds that it exceeds the authority of the Centers for Medicare & Medicaid Services.

Judge Matthew Kacsmaryk could rule at any time, and should he find in favor of providers, experts have said an appeal by new HHS and CMS leaders is unlikely.

The Centers for Medicare & Medicaid Services has released its official 2025 mission and priorities document. One of the department’s areas of emphasis includes upholding staffing requirements and ensuring compliance with Payroll-Based Journal dictates.

Payroll-Based Journal staffing data usage will be used to help surveyors identify potential noncompliance with agency staffing requirements, CMS said, including the lack of a registered nurse for eight hours each day or a lack of licensed nursing for 24 hours. Read the whole story.

In a presentation by Lynn Fieldhouse of Signature Healthcare and Drew Graham of Hall Booth Smith on “Issues, Considerations, and Defense Strategies for Dealing with the Staffing Crisis” at the 2022 DRI Senior Living and Long-Term Care Seminar, it was clear from their remarks that providers must aggressively defend understaffing cases, as staffing data does not elucidate the full story of care provided.

Among several components of an effective defense against staffing allegations, Mr. Graham included the use of experts in staffing, economics, and financial and cost reporting.  The use of the PBJ staffing data during the residency dates is important in showing the absence of staffing concerns.

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