Republicans Delay Vote on CRA Resolution to Repeal Biden’s Nursing Home Staffing Rule

Four individuals in formal attire standing together.

Republicans delay a critical vote on repealing Biden’s nursing home staffing rule, leaving the fate of many rural facilities on the line.

At a Glance

Sen. Jon Tester introduced a CRA resolution to overturn the Biden Administration’s nursing home staffing mandate.
The resolution has bipartisan support but faces a likely presidential veto.
Critics argue the staffing mandates could exacerbate workforce shortages and force rural nursing homes to close.
Alternative legislative and legal strategies are being considered to halt the policy.

Republicans and the Congressional Review Act

U.S. Senator Jon Tester has introduced a Congressional Review Act (CRA) resolution alongside Republican colleagues to overturn the Biden Administration’s new nursing home staffing mandate. This rule requires nursing homes to have a registered nurse on duty 24/7 and mandates a minimum of 3.48 nursing care hours per resident daily. The CRA allows Congress to overturn federal agency rules with a simple majority vote in both the House and Senate.

Sen. James Lankford expressed concerns over a potential presidential veto, making passage challenging despite bipartisan support. The CRA resolution enjoys sufficient backing to pass in both chambers, helmed by Senators Jon Tester (D-Mont.), James Lankford (R-Okla.), and Joe Manchin (I-W.Va.). Tester has been fiercely opposing the mandate, citing its detrimental impact on rural healthcare facilities already grappling with workforce shortages.

GOP won’t force a vote to overturn nursing home staffing rule https://t.co/BjwhKzxtwL

— The Hill (@thehill) September 17, 2024

Impact on Rural Nursing Homes

The primary critique of the Biden administration’s staffing rule is its impracticality for rural nursing homes facing severe staffing shortages. “Too many folks in Washington don’t understand the challenges that long-term care facilities in rural areas face,” said Tester. He argues that such facilities might be forced to close, which, in turn, would negatively impact elderly care in rural America. In Montana alone, several nursing homes have closed, losing over 850 beds in 2022.

“deeply concerned that now is the worst possible time for the United States to establish the nation’s first federal staffing mandate for long-term care facilities.”

The measure also drew criticism from Clif Porter of AHCA/NCAL, who supports legislative efforts to overturn the staffing mandate, and the American Hospital Association (AHA). The AHA sent letters to Senate and House members urging them to halt enforcement of the mandate, as they believe it could stifle innovation and lead to reduced capacity or the closure of well-performing nursing homes. The CMS estimates that 79% of long-term care facilities would need to increase staffing, a task that is nearly impossible given current workforce shortages.

Alternative Paths and Ongoing Legal Battles

Considering the potential veto by President Joe Biden, alternate strategies to obstruct the staffing mandate are being explored. One such route is Tester’s bipartisan Protecting Rural Seniors Access to Care Act, designed to prevent the finalization of the staffing rule. Tester, along with other bipartisan signatories, has been vocal in their letters to CMS Administrator Chiquita Brooks-LaSure and Veterans Affairs Secretary, highlighting the rule’s adverse effects on veterans’ access to long-term care in rural areas.

“Lastly, we believe this final rule could exacerbate the already serious shortages of nurses and skilled health care workers across the care continuum. The agency estimates that 79% of LTC facilities would have to increase staffing to meet the proposed standards, including the new standard requiring 24/7 RN staffing.” AHA wrote.

Meanwhile, litigation efforts are concurrently running in Texas, arguing against the enforcement of the staffing directives. The timing for a vote on the CRA resolution remains uncertain. However, as bipartisan support mounts and alternative measures are put forth, the debate over the Biden Administration’s nursing home staffing rules is far from resolved.