June 6, 2022 Washington, DC –– With the June 10 deadline to submit comments to the Centers for Medicare & Medicaid Services’ (CMS) on its 2023 Skilled Nursing Facility proposed payment rule fast approaching, a top aging services leader warned CMS that reducing payments and imposing staffing requirements may well hinder older adults and families from being able to access the care and services needed to age well.

“Access to quality nursing home care is a shared goal. Older adults and families need it; policymakers and providers are committed to ensuring it. Yet a crisis is unfolding across America today as that access is increasingly threatened,” said Katie Smith Sloan, president and CEO of LeadingAge, the association of nonprofit providers of aging services, including nursing homes. “Numerous factors—from inflation-induced increases in operating costs and insufficient support from policymakers, to staff shortages and recruitment and retention issues in a tight labor market—increasingly put much-needed 24/7 nursing homes care out of reach.”

“Funding goes hand in hand with quality care. Do not add to the chronic financial neglect of our nations’ nursing homes by implementing the cuts in the proposed payment rule. Now is simply not the time.”

Describing the impact of potential staffing mandates on nursing homes already buckling from sustained pressure of staffing shortages, Sloan said: “Across the country, older adults will not be able to access care because providers will be forced to limit admissions. Just this week, one administrator in Kansas told me he’s got a waiting list of residents, but not enough staff to admit. He’s contracted with four staffing agencies, but not one can provide a licensed registered nurse. His story is not unique. Some of our members have already said the situation is unsustainable and have been forced to close.”

Our message to CMS: This is not the time to cut payments. And, without sufficient support, mandates on staffing are meaningless. As proposed, this rule may well be the final blow for more nursing homes serving older adults across the country.”

Comments from LeadingAge nursing home members on the impact of the proposed rule:

• “Today, frail older adults have limited options for care and support; most providers have already reduced services because of uncompensated care. The unfunded mandate to increase the cost of additional staffing will result in providers turning away more people in need. We have seen families in crisis looking for a place for a loved one with limited to no options.” —Laura Roy, Executive Director, Passavant Community, Lutheran Senior Life, Zelienople, PA
• “Any further cuts bring us to a question of whether skilled nursing care will truly be sustainable in many communities. South Dakota has had four nursing homes announce this year that they are closing, and it’s highly likely there will be more doing the same. In a rural state with great distances between communities and aging sector resources, that has a huge, sometimes devastating impact on individuals in need of services and their families.” —Deb Paauw, Executive Director of Quality and Data Integration, Avera, Sioux Falls, SD
• “Nothing has gone down [in price]: personal protective equipment, food, other supplies…. Wages are way up. [The Biden Administration] needs to understand that the hourly wage of staff is through the roof… It is killing us. It’s all about being able to care for our community. Without being able to hire staff, we can’t do that.” —Joel Smith, Health Services Administrator, BayView Life Plan Community Seattle, WA
• “Staffing requirements will be too high to meet since CMS expects higher staffing levels [during a severe workforce shortage] and with much lower reimbursement, which creates an unfunded mandate.” —Brian Robbins, Vice President & COO, Buckner Retirement Services, Dallas, TX

We represent more than 5,000 nonprofit aging services providers and other mission-minded organizations that touch millions of lives every day. Alongside our members and 38 state partners, we use applied research, advocacy, education, and community-building to make America a better place to grow old. Our membership, which now includes the providers of the Visiting Nurse Associations of America, encompasses the continuum of services for people as they age, including those with disabilities. We bring together the most inventive minds in the field to lead and innovate solutions that support older adults wherever they call home. For more information visit leadingage.org.