Hello LeadingAge Missouri Members!
With “trick or treating” just ahead, it’s time to decide who I’ll be for Halloween! Perry Mason? Atticus Finch? Elle Wood? Lt. Daniel Kaffee? Erin Brockovich? A lawyer for sure, because my perspective right now is on lawsuits, or more precisely, one lawsuit: State of Missouri & LeadingAge Missouri et al, Plaintiffs v. Xavier Becerra, Secretary of U.S. Department of Health and Human Services and Chiquita Brooks-LaSure, Administrator of the Centers for Medicare and Medicaid Services, Defendants
That’s right, our State and your association are now co-plaintiffs – alongside 19 other states and 20 other LeadingAge State Affiliates – in a lawsuit pending in Iowa Federal Court against HHS and CMS to overturn CMS’ staffing mandate. As we’ve communicated, while we share CMS’ goal of ensuring all nursing home residents receive quality care, we don’t think a one-size-fits-all, inflexible staffing mandate is the right approach – especially since nursing homes can’t find enough RNs and CNAs to meet CMS’s staffing ratios, AND even if they could, they can’t afford them. Bottom line: LA MO and Missouri can’t support a staffing mandate without improvement in the healthcare labor market and higher reimbursement from CMS for nursing home care.
The LA MO Board voted unanimously to advance your interests and join the lawsuit to enjoin burdensome requirements and huge costs being imposed on nursing homes, state budgets, and Missouri taxpayers. To comply with CMS’ rule, Missouri SNFs must hire 1,600 more RNs and 2,500 more CNAs at a cost of more than $500,000 for each Missouri nursing home. That’s 2-3 more nurses and 5 CNAs at every home, which is simply untenable. Today, there are approximately 1,667 RN vacancies in LTC communities. How can we fill those and 1,600 more? Thirty-four Missouri nursing homes have already closed due to unavailable staff or insufficient reimbursement, or combination of both. Others downsized to survive. The staffing mandate will cause many more SNFs to downsize or close – especially in rural communities. At best, we will have reduced access to healthcare for older Missourians – a bad result. At worst, with the largest generation in history about to need aging services, fewer and smaller SNFs could spell crisis.
The central motivation for LA MO joining the litigation was to push back on untenable staffing requirements detrimental to nursing home members and other SNFs across the nation. We are the trusted voice for aging! Our national partner, LeadingAge, filed a similar, but separate, suit in Texas Federal Court. The Iowa litigation bolsters the Texas case and offers different options for affected parties to oppose the mandate, protect LTC access, and expand discussions with CMS about non-punitive, oversight.
Another reason to join the Iowa litigation is to optimally position LA MO members for injunctive relief. If the Iowa Court is persuaded to enjoin implementation of CMS’s staffing mandate, the Court may opt for narrow judicial relief – the Court could decide only parties to the litigation are relived of complying with the CMS rule. Accordingly, to best advance and protect LA MO member interests, we opted to be part of the lawsuit.
And LA MO was instrumental in bringing Missouri’s Attorney General to the party! In July, we met with AG Andrew Bailey’s office to suggest he pursue any of several legal options to protect Missouri SNFs, MO HealthNet, and Missouri taxpayers. We are pleased we helped persuade the Attorney General to ally with us in the Iowa option!
Happy Halloween!
Bill