Mayes, other AGs file letter challenging decision to repeal nursing home staffing mandates

Late last year, the Centers for Medicare and Medicaid repealed parts of the Biden administration’s nursing home staffing requirements. Now, Arizona Attorney General Kris Mayes joined a coalition of other AGs in filing a letter challenging the decision.

The staffing mandate would have required nursing homes, including the nearly 200 facilities here in Arizona, to provide more than three hours of direct care per resident, per day. Facilities would also have to have a registered nurse on staff 24 hours a day, seven days a week. Mayes and the other AGs argue that data proves that higher staffing rates are associated with positive health outcomes.

Long term care facilities, particularly those in rural and tribal communities, raised concerns about the challenges they currently face when it comes to recruiting nurses and other long-term care staff.

David Voepel with the Arizona Healthcare Association, which represents long term care, said the mandate, “was never serious public policy.” The AGs are asking CMS to enact a more tailored mandate that would exempt tribal nursing homes, government owned and not-for-profit facilities.

All comments were due Feb. 2.

Voepel issued this complete statement:

"Unfortunately, the federal staffing mandate was never serious public policy. It was a political solution in search of a workforce that does not exist.

The rule failed repeatedly across multiple venues, from the federal courts to Congress, because of fundamental flaws in its design. It was entirely unfunded, untethered from actual labor supply, indifferent to regional variation, not meaningfully risk-adjusted, and legally overreaching.

At its core, the mandate imposed uniform national staffing thresholds on nursing homes that were, and in many cases still are, facing historic workforce shortages. It ignored differences in patient acuity, rural versus urban labor markets, and wide variation in state Medicaid reimbursement structures. By design, it attempted to achieve through regulation what could not be achieved through legislation."