Congressional Letter: CMS Nursing Home Proposal Has Several Critical Issues

​A proposal by the Centers for Medicare and Medicaid Services (CMS) to revise nursing home regulations has several critical issues, said more than 30 members of Congress in a July 20, 2016, letter to the acting administrator of CMS. The proposed "Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities CMS-3260-P" includes many positive provisions, signers of the letter said, but certain issues must be addressed in order to "truly ensure the care and safety of this vulnerable population." The first issue regards inadequate staffing. The authors urged CMS to require that a registered nurse (RN) be on duty at a nursing home facility 24 hours a day, seven days a week, in order to provide direct care, resident monitoring, and assessment. The authors also expressed regret that the proposed rule does not have a minimum nurse staffing standard. They suggested that CMS consider a minimum standard of 4.1 hours of direct care nursing time per resident day.