In observance of Passover, there will be no Digest next week. We will return on Monday May 6^th. Happy Holidays to all who celebrate!

MONDAY AFTERNOON (4/22) 130 PM EST:

The White House announced this morning that they will be releasing the final SNF minimum staffing rule later today (4/22). Rules are typically posted to the Federal Register at around 415 PM EST. For now, the only publicly available information is contained within the official Fact Sheet.

AHCA will be hosting a member-wide webinar tomorrow (4/23) at 1 PM EST. This is for members-only and registration is required.

For those unable to participate in tomorrow’s webinar owing to Passover, AHCA, together with the Ambassadors Group, has graciously arranged a second webinar for after the holiday. Please consult with your state association for more details and how to register.

Here are some links to press coverage on the rule:

· McKnight’s

· Fierce Healthcare

· CNN

· USA Today

· The Hill

WHITE HOUSE:

The White House focused this week on releasing the new US global health security strategy, a guide to the United States role in partnering with the global health community (available here as a PDF), a new MOU with Norway to build stronger cooperation in the global supply chain for “critical minerals” and protecting the US steel and shipbuilding industry from interference by China. Two items of interest to us:

• On the one-year anniversary of the President’s Executive Order to support caregivers, they provided a progress report on the federal efforts since then. Included in the announcement were two very useful guides that highlight federal programs that are available to build workforce:

• An overview of the actions by federal agencies to support the workforce titled “Advancing Care As A Supportive Service” (PDF). It’s a very useful rundown of the many different federal investments available for workforce development.

• The Department of Labor released new guidance to federal agencies on how to build workforce development for childcare and long-term care workers. It’s available here.

• They released a new “Memorandum of Agreement” (MOA) among federal agencies to assist the spouses of military families in finding more meaningful and permanent employment. While primarily focused on telework, there may be strategic opportunities to find employment, especially if you’re located near a military installation.

CONGRESS:

With the need to pass some form of foreign aid for Israel and Ukraine growing with each passing day, Congress passed on package of ‘stand-alone’ bills to provide funding. As discussed in past weeks, in order to get the bills out of committee, “unprecedented” Democratic support was needed, a process that is making Speaker Mike Johnson’s political situation ever more precarious. Despite the fury of far right conservatives over the vote, the bills are expected to pass the House, and eventually become law, despite conservative opposition in the Senate. Given the Speaker’s increasing reliance on Democrats to pass necessary legislation, Democrats in the House are strategizing about the best way to politically capitalize on the situation. The chaos is leading to more internal frustration in the GOP with their conservative flank. For now, with foreign aid likely in the rearview mirror, Congress continues to chug along. Elsewhere in the political world:

• We mentioned last week a new federal effort to rein in private equity in healthcare. The Wall Street Journal explored what steps states are taking to deal with the situation.

• The Senate Special Committee on Aging held a hearing on the long-term care workforce and how to navigate the shortage. You can watch the hearing here. Both McKnight's and Skilled Nursing News have summaries.

• This may be of interest only to the politically wonky among us, but a by-product of the internal chaos among the GOP, is the political tactics being employed by the different groups to protect their roles, including a new “Fast Action Response Team” that is literally on the House floor at all times to protect against unwanted legislative amendments that may be limit their power.

• The House Energy & Commerce Committee held the first of several planned hearings on healthcare cybersecurity in the wake of the Change cyberattacks. Axios has a good summary.

• Two interesting retrospectives, here & here, on how Speaker Johnson did a 180 and decided to push through with foreign aid, despite the threat to his political future.

• As AI becomes ever more prevalent, Politico did a deep dive into how it’s going to affect this year’s election season.

• Two CRS Reports from the week, that are updated versions of past reports, but are relevant to topics that are of importance to SNF’s (PDF links):

• A review of the Congressional Review Act that will dictate timing on the release of the minimum staffing rule as it governs the Congressional ability to overturn an agency issued rule.

• An overview of the Pact Act that governs the new legislation expanding the eligibility of veterans to tap into federal healthcare programs.

AGENCIES:

While the release of the staffing rule is imminent, it was a quiet week for the agencies.

ARPA-H announced an interesting program this week called BREATHE (Building Resilient Environments for Air and Total Health). The goal of the program is to builder smarter and more efficient indoor air systems, something that was very relevant to SNF’s during Covid. It’s a program to monitor.

The OIG at HHS announced a planned audit of UPL programs, scheduled for released sometime in 2025. This would be an audit of how state’s with UPL programs are complying with federal requirement related to their UPL programs.

One SPA from the week: North Dakota received approval for an update to their SNF incentive program. It’s available here (PDF).

FROM THE NOTEBOOK:

• The survey reform legislation in Pennsylvania is progressing through the state legislature, thanks to the strong efforts of PHCA.

• South Dakota created 2 new grants, totaling $7 million, to spur new tech innovation in SNF’s meant for telehealth and other initiatives.

• What do you know? It’s not just providers that are having staffing challenges. The government of Ontario is having trouble meeting their workforce goals as they simply can’t find nurses to hire.

• We’ve tracked efforts at the state level to provide Medicaid to folks who are incarcerated. The Kaiser Family Foundation broke down which states are requesting waivers from CMS to build these programs.

• They also released a new data brief on consolidation in the healthcare field, a topic that is of major interest to policymakers now.

• The NY Times did a retrospective on the Medicaid Unwinding.

• It’s not just SNF’s that are embroiled in conversations related to minimum staffing. Kaiser Health News looked at efforts at the state level to impose minimum staffing levels at hospitals.

• Techcrunch explored the growth of generative AI in healthcare and the public response.

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