For Immediate Release
October 9, 2024

Media Contact:
Kierstin Reed, CEO, LeadingAge Nebraska
[email protected]
402-770-4627

LeadingAge Nebraska Joins 20 Other State Affiliates & 20 Attorneys General in Lawsuit to Overturn CMS Staffing Mandate

Lincoln, NE- A total of 21 LeadingAge state affiliates, membership associations that represent hundreds of not-for-profit aging services providers across the country, have joined a lawsuit with 20 Attorneys General to overturn the Centers for Medicaid and Medicare Services’ (CMS) staffing mandate. Filed by the Attorneys General from Iowa, Kansas, and South Carolina on behalf of LeadingAge Iowa, LeadingAge Kansas, and LeadingAge South Carolina, and other state affiliates, in the United States District Court’s Northern District of Iowa, the complaint intends to overturn the mandate itself and vacate certain of the more onerous requirements in the rule.

In April, CMS released the Nursing Home Minimum Staffing Standards final rule to the Federal Register. The rule requires all federally funded nursing homes to produce a revised facility assessment and changes the minimum number of hours per resident day (HPRD). All providers must provide 3.48 hours of direct nursing care per patient, per day and staff a registered nurse 24 hours a day. These specific breakdowns also require 0.55 RN and 2.45 certified nurse aide (CNA) coverage per patient, per day.

These newly-prescribed HPRDs mean nursing homes across the U.S. will need an additional 27,000 full-time registered nurses (RNs) and 78,000 full-time nurse aides costing over $7 billion—an impossible requirement to meet amid a worldwide nursing shortage and dismal Medicaid reimbursement rates that do not fully cover the actual cost of care. Sadly, the HPRD limits the utilization of licensed practical nurses (LPNs) who provide most of the direct patient care in nursing homes, potentially displacing thousands of these workers across the U.S.

“The Final Rule has already forced our nonprofit and mission driven nursing homes to make difficult decisions about reducing their skilled nursing offerings, decertifying their skilled nursing beds, and in some cases closing their buildings all together. This affects our entire healthcare system and limits older adults’ ability to receive care, especially in rural areas. We are amid the largest workforce shortage in our country and with the closure of skilled nursing communities, older adults and family members will have to travel great distances to receive care. The Final Rule will also exacerbate the wait times for long-term care services in our state,” LeadingAge Nebraska’s CEO, Kierstin Reed, said
LeadingAge Nebraska’s Board Chair, Lois Jordan, CEO of Midwest Geriatrics, which operates Florence Home in Omaha, NE, noted that the industry needs solutions to the workforce shortage, not unattainable mandates.

“LeadingAge Nebraska's members have voiced strong concerns about the known impact the staffing mandate will have on seniors in the state. The mandate, which limits the role of Licensed Practical Nurses (LPNs) from skilled care settings, is expected to significantly increase staffing costs, directly affecting seniors financially. Coupled with existing nursing shortages, this would make it nearly impossible for communities to continue operating effectively. Recognizing the gravity of the situation, the association felt compelled to take decisive action against this ill-conceived ruling. Senior care professionals understand the importance of maintaining optimal staffing ratios, and tried to make this clear to the Centers for Medicare and Medicaid, to collaborate on a feasible path forward. Unfortunately, that request was ignored. With the wellbeing of more than 10,000 Nebraskans requiring care in a nursing home, legal action became our only option.”

Brody Chandler, LeadingAge Board Chair-Elect, Executive Director, Immanuel Lakeside, Omaha, NE, further reiterated “CMS is instituting a staffing mandate that cannot and will not achieve its stated goal of ensuring older adults access to high-quality nursing home care. The unintended consequences of this mandate may very well prove catastrophic for the healthcare industry. With the current staffing crisis faced by the healthcare industry, there will be nursing homes that cannot meet the unrealistic requirements of this mandate. These nursing homes will be forced to decrease capacity or worse, close their doors. This may cripple the healthcare continuum of care. Our goal from the beginning has been to work with CMS to craft a realistic and attainable model. Their refusal to engage organizations like Leading Age to craft meaningful policy has left us no choice but to fight back for our residents and all older adults.”

Reed commented, “We are thankful for Attorney General, Mike Hilgers, for joining this suit to fight for the elders, healthcare system, and taxpayers in Nebraska and nationwide that will be gravely impacted by this unfunded and unlawful mandate.”

About LeadingAge Nebraska
LeadingAge Nebraska is an association of non-profit and mission-driven aging services providers serving older adults across Nebraska. We advocate for the highest quality services for older adults and those who serve them and we champion, equip, and advocate for non-profit and mission-driven aging services providers. LeadingAge Nebraska strives to be known as the trusted voice in aging by collaborating with providers to strategically manage change, innovate, and advocate to transform an aging in Nebraska. Learn more at www.leadingagene.org.

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