| NURSING HOMES NEED TO STAFF UP — CMS has finalized a new staffing requirement for nursing homes despite broad opposition from the industry, POLITICO’s Robert King and Daniel Payne report. The rule, released Monday, will lead to nearly 8 in 10 homes being forced to hire additional staff, according to a senior Biden administration official not authorized to speak publicly. CMS, however, gives nursing homes some leeway to comply with requirements that include an on-site nurse 24/7. A rural home has three years to comply, and an urban home has three years. Facilities that don’t comply could face escalating penalties. Some changes have been made to last year's original proposal. A nursing home can now apply for an exemption to the 24/7 requirement if it can prove difficulty in hiring additional staff. The exemption would give an eight-hour reprieve from the requirement, but other staff such as a physician’s assistant must still be on hand. “We believe our final rule is responsive to all of those comments received from a variety of different voices,” said another official granted anonymity because they were not authorized to be quoted by name. CMS pursued the rule to improve care in nursing homes, which were hit hard during the Covid-19 pandemic. The rule garnered significant opposition from the nursing home industry. “Our residents and our families are going to have to go further to access care,” said Nate Schema, president and CEO of the Good Samaritan Society, which operates nursing homes. But patient advocates, health worker unions and administration officials said that the rule would help improve care for older Americans. “The provisions that make up the nursing home staffing rule mark a long-overdue sea change,” Mary Kay Henry, president of SEIU International, a labor union, said in a statement. MEDICAID RULES FINALIZED — In keeping with its Monday output, the Biden administration finalized two rules to strengthen Medicaid. One rule, which applies to Medicaid managed care plans and the Children’s Health Insurance Program, sets maximum appointment wait-time standards for patients, which will be monitored through surveys. Additionally, states’ websites, where managed care plans’ quality ratings are publicly posted, must include information to help people compare plans. The second rule, which applies to Medicaid fee-for-service, sets minimum thresholds for payments to direct care providers: States must ensure that a minimum of 80 percent of Medicaid payments for direct care providers like home health aides and personal care services be used for worker compensation instead of overhead costs. It also expands requirements for state committees that advise on Medicaid managed care, including posting meeting minutes and making their membership lists available. While progressive group Protect Our Care praised the rule, Rep. Cathy McMorris Rodgers (R-Wash.), chair of the House Energy and Commerce Committee, said the rules create “untenable standards for home health agencies to meet.”
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