Association's rationale is America’s current infrastructure of long-term care cannot sustain staffing mandates until they are supported by adequate funding and available staff.
Pushing back on criticism that opposition to the Center for Medicare and Medicaid Services (CMS) minimum staffing standards final rule has “no justifiable rationale” and allegations that greed is the basis of efforts to halt the rule’s implementation, LeadingAge president and CEO Katie Smith Sloan set the record straight.
In a July 8 letter to Senator Elizabeth Warren and Representative Jan Schakowsky, Sloan writes: “Since the Biden Administration’s initial call for a staffing mandate with the 2022 release of its Action Plan for Nursing Home Reform, we have repeatedly expressed our alignment with the goal of ensuring all older adults and families can receive quality care. ... While we agree on the goal … we disagree on the use of mandates to achieve it.”
The rationale for the position taken by the association she leads, whose more than 5,400 nonprofit and mission-driven members serve older adults in a range of care settings and community types across the aging services continuum—including but not limited to nursing homes—is simple: America’s current infrastructure of long-term care cannot sustain staffing mandates until they are supported by adequate funding and available staff. Sloan explains that, “as we said when announcing our board-approved decision to join as co-plaintiff in the lawsuit challenging the final staffing rule, we are opposed to this mandate because it does not acknowledge the interdependence of funding, care, staffing, and quality.”
Advocacy initiatives and lobbying are critical, she argues, to the association’s efforts on behalf of older adults and the members who serve them. Money spent to support that work, which is disclosed quarterly and annually as required by federal law, “demonstrates our commitment to dedicating resources to improving and expanding programs that serve older adults,” Sloan writes. “We cannot overemphasize the serious gaps in America’s long-term services and supports financing system that the staffing mandate lays bare. Addressing these gaps can be done only by Congressional action—and our advocacy sounds the alarm on this to ensure that older adults can access care and providers will have the resources necessary now and in the future.”
She adds: “Despite the billions of dollars in federal funds spent annually on Medicare, Medicaid, and affordable housing, for example, we believe the federal government has a responsibility to do more. Our country is rapidly aging, and we are not prepared to meet the growing demand for services and supports that will result. Thus, we advocate for these programs—including those that will expand the long-term care workforce, increase health care reimbursement rates to cover the cost of care, and expand the supply of affordable housing—all to do better by older adults.”
Finally, Sloan says, “we are committed to our advocacy initiatives related to staffing mandates and other issues, and to stand by the financial decisions we make to support our organization’s mission.” Seeking to address the challenge inherent in LeadingAge’s nonprofit and mission-driven providers’ first-hand knowledge that the staffing mandate is unrealistic and our goal, shared with Senator Warren and Representative Schakowsky, of ensuring older adults’ access to quality care, Sloan ends on a collaborative note: “We look forward to working with you to meet the needs of America’s older adults.”
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