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“It’s a Misguided Mandate That Will Prove Destructive for the Communities That Most Need Care.”

WASHINGTON, D.C. – In a speech on the Senate floor, U.S. Senator Deb Fischer (R-Neb.) criticized a recent rule from the Centers for Medicare and Medicaid Services (CMS) that mandates new minimum staffing standards for long-term care facilities.
 
Senator Fischer argued that the rule could force many nursing facilities around the country to close, which would especially devastate rural communities. According to CMS, 75% of nursing homes nationwide would need to increase staffing levels to comply with the proposed standards — even as long-term care facilities face historic staffing shortages.
 
During her remarks, Senator Fischer announced her intent to introduce legislation preventing these standards from going into effect and establishing an advisory panel on the nursing home workforce.

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Following is a transcript of Senator Fischer’s remarks as prepared for delivery:

Across the country, over 1.2 million Americans live in nursing homes. Many of our own parents, grandparents, and other loved ones are among them. Nursing facilities provide specialized, attentive care to seniors in critical need of their services.

Long-term care facilities are especially indispensable in small towns and rural areas like much of my home state of Nebraska. In those areas, a larger percentage of the population is over 65.

Unfortunately, the Biden administration released a rule this fall that could force many nursing facilities around the country to close their doors.

The new rule, introduced in September by the Centers for Medicare and Medicaid Services, mandates new minimum staffing standards for long-term care facilities. It requires each facility to staff a registered nurse on site 24/7 and would require staff to provide each resident with at least three hours of direct care per day.

The administration believes this rule would improve the quality of care in our nursing facilities. Unfortunately, the rule as written would simply force many facilities to shut down — denying care to seniors entirely.

According to CMS, 75% of nursing homes would have to increase staffing to comply with these proposed standards. But across our country, these homes already face historic staffing shortages.

According to federal labor statistics, nursing homes lost more than 200,000 workers from February 2020 to December 2022. The industry is still rebuilding its workforce after a devastating pandemic.

Under this rule, nursing homes would be forced to go to great lengths to find staff in the midst of these overwhelming shortages. If they failed, they would likely need to shut their doors, depriving seniors of care.

Even one nursing home closure could be detrimental to seniors in certain rural communities. Highly populated urban areas may host several long-term care options — but these facilities are few and far between in the rural areas of our country.

If one facility closes, the next closest one could be many miles or even hours away. It might not be feasible for every senior to move so far from home.

This mandate from CMS would devastate facilities across Nebraska, across rural America, and across the country. It would devastate families who are relying on these facilities to serve their loved ones. And it would devastate the seniors who urgently need care. 

After the release of this proposed rule in September, I joined the rest of the Nebraska delegation in sending a letter to CMS Administrator Chiquita Brooks-LaSure opposing the new standards.

We never received a response.

I plan to introduce legislation that would prevent these misguided standards from going into effect. My bill would also establish an advisory panel on the nursing home workforce. The panel would host members representing various stakeholders — including members from rural and underserved areas.

The Biden administration must hear from voices outside the big cities on the coasts. This proposed rule is a one-size-fits-all attempt at a solution — but the so-called solution simply doesn’t fit.

It’s a misguided mandate that will prove destructive for the communities that most need care.

I’ll keep fighting for our rural communities and for the seniors who rely on long-term care facilities. I encourage my colleagues to do the same by joining me in support of this legislation to protect nursing homes and the Americans they serve.

Thank you, Mr. President, I yield the floor.

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