Skilled Nursing Providers: Take Action Before the Senate Passes the Build Back Better Act!

Posted on December 16, 2021 by Matt Steele

The Build Back Better Act (BBB) currently being debated in the Senate requires nursing homes to have a registered nurse on staff 24 hours a day.

The U.S. House of Representatives passed the Build Back Better Act (BBB) on Nov. 19. While the BBB includes several benefits to support long-term care, such as the expansion of home and community-based services, increased workforce funding, and investments in affordable housing, there is a concerning component of the bill related to staffing that will negatively impact the delivery of care. The bill requires nursing homes to have a registered nurse on staff 24 hours a day.

We are grateful that lawmakers made a few minor changes regarding the nursing home staffing provisions in the bill. The provision relating to implementing staffing ratios has been changed. It still requires CMS to do its staffing study but no longer requires CMS to issue regulations implementing the study's findings. Instead, CMS will report to Congress and update the study every X number of years. However, the very concerning provision, which would require 24-hours per day R.N. coverage effective 2024, is still in the bill.

This nursing home staffing mandate in the BBB bill fails to consider the workforce crisis facing long-term care settings and the reality that over 75% of providers are limiting admissions as a result. We cannot mandate stricter staffing ratios and more registered nurses unless we have practical solutions to growing our available workforce pool. Without funds to pay additional staff and provisions to consider the reality of our labor shortages, this mandate will only lead nursing homes further towards closing altogether, leaving older adults without access to critical service.

With Minnesota Senator Amy Klobuchar reporting to the media on Dec. 12 that her colleagues will do "everything to get" the BBB bill passed by Christmas, we have a very short time to act and need your help!

Contact Sens. Amy Klobuchar and Tina Smith here and let them know that to care best for Minnesota seniors, we need them to remove this mandate before the Senate passes the BBB.