Tester, Barrasso, Hickenlooper, Daines Push Biden Administration to Better Address Rural Nursing Home Staffing Shortages

In their continued effort to ensure seniors across rural America have access to quality long-term care, U.S. Senators Jon Tester (D-MT), John Barrasso (R-WY), John Hickenlooper (D-CO), and Steve Daines (R-MT) sent a letter to the Center for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to express concerns about CMS’ intent to issue staffing mandates for nursing homes. In the letter, the Senators discourage CMS from taking a “one-size-fits-all” approach and instead urge them to address the significant workforce shortages affecting rural America.

The letter was also signed by Senators John Thune (R-SD), Gary Peters (D-MI), Kevin Cramer (R-ND), Joe Manchin (D-WV), Deb Fischer (R-NE), Kyrsten Sinema (D-AZ), John Hoeven (R-ND), Cynthia Lummis (R-WY), and Mike Rounds (R-SD).

“We fear a one-size-fits-all staffing mandate would undermine access to care for patients, particularly in rural communities,” the Senators wrote. “Instead, we urge you to work with Congress and rural stakeholders on tailored solutions that address the severe workforce challenges in our states’ underserved areas.”

“Going forward, we recognize CMS as a crucial partner in identifying, mitigating, and preventing future health and safety problems in nursing homes,” the letter continued. “We stand ready to work with your agency on proposals to improve long-term care for patients. The best way to accomplish this goal is working with Congress and stakeholders to ensure any future actions do not further exacerbate the serious challenges already facing facilities in rural America.”

In recent years, staffing issues and nursing home closures have limited access to senior care in rural communities. Since 2021, Montana has seen the closure of 11 nursing homes, and in 2022 alone, the state lost more than 850 nursing home beds, according to the Montana Health Care Association.

In the wake of the COVID-19 pandemic, nursing homes have struggled with nurse recruitment and retention, especially in underserved communities. Staffing mandates would put an additional burden on rural nursing homes, which face different workforce conditions and patient needs than their urban counterparts. These blanket mandates would also place a disproportionate financial burden on rural nursing homes and could potentially result in additional closures that would be detrimental to underserved communities.