Advocates and Members Urge Retention of CMS Minimum Nursing‑home Staffing Standards

WASHINGTON — At a March hearing on post‑acute care, advocates and some lawmakers urged the House Ways and Means Health Subcommittee to preserve new federal nursing‑facility staffing requirements, saying the rules would improve resident outcomes and save lives.

"These standards require a registered nurse around the clock," Eric Carlson of Justice in Aging told the subcommittee. He summarized the final CMS rule as requiring at least 3.3 hours of direct care per resident per day, including about 2.5 hours from nurse aides, and a registered nurse on site 24 hours a day.

Carlson and other witnesses cited research estimating the rule could prevent thousands of deaths annually. "Researchers at the University of Pennsylvania estimate a savings of 13,000 lives annually," Carlson said. Witnesses added that staffing requirements include phase‑in periods and hardship exemptions for rural providers facing genuine labor shortages.

Republican members questioned the rule's practicability in rural areas and warned of facility closures if staffing cannot be found. In response, Carlson emphasized both the phase‑in timeline and hardship exemptions and noted the rule is targeted to address historically inadequate staffing levels and associated harms such as bed sores, falls and infections.

Members asked witnesses about workforce constraints and retention strategies. Witnesses and some members recommended improving wages, working conditions, and investment in recruitment and training rather than rolling back the federal standard.

No legislative action was taken during the hearing. Witnesses urged the committee to balance regulatory relief with measures to preserve resident safety while considering workforce supports and implementation timelines.