(Adds comment from the American Health Care Association, paragraphs 6-10.)

Seventeen Senate Democrats signed a letter blMX released on Wednesday outlining a sweeping set of changes for the long-term care system that these lawmakers hope will be a blueprint for action if their party can take control of Congress after the midterm elections in November.

Signed by Senate Finance Committee Ranking Member Sen. Ron Wyden (D-Ore.), among others, the letter contains a list of changes the Democrats want to install through legislation, including resurrecting a nursing home staffing mandate, which the skilled nursing sector has called an “existential threat” to the operation of facilities.

The talk of mandates returning to the policy debate, and a slew of other Democrat priorities has increased in recent weeks as polls show both houses of Congress in play in November.

In an exclusive talk with Park Place Live on Tuesday, former leading CMS official Jonathan Blum, said, “I think that Congress and advocates for staffing mandates” will certainly act if Democrats return to power. But with the White House in control of President Trump, the time frame for actually having a real chance to enact such changes is in the 2029-2030 time period if Democrats also win the presidency, he said.

Blum said there are also continued concerns that a Democratic Congress would seek to address legislatively, like transparency in the ownership structure of SNFs, Medicare and Medicaid financial pressures, more examination of margins and financial profitability in the sector, and the aforementioned staffing mandates.

AHCA Responds

In response to the letter, Clif Porter, the president and CEO of the American Health Care Association, said the goal for the sector remains providing top-quality care for residents.

“As a profession, we continue to support commonsense policies that strengthen and modernize long-term care so that seniors and individuals with disabilities can access high-quality care in the setting that best meets their needs,” he said.

“While we share the goals of improving quality, upholding reasonable transparency, and building a sustainable workforce, new policies must also recognize and address current challenges, such as chronic underfunding and labor shortages, that permeate the sector.” 

Porter said seniors and their families can’t wait and that is why the association and its members are “already striving to advance rational and achievable solutions through our Caregivers for Tomorrow initiative and Better Way policy priorities.”

AHCA/NCAL (National Center for Assisted Living), he stressed, “remains committed to working with lawmakers and other stakeholders to develop bipartisan and balanced solutions that promote high-quality care, strengthen our workforce, and ensure that long-term care services are accessible to those who need it.”

Mandate

Democrats in the letter said Republicans repealed minimum staffing standards in nursing homes, “denying residents and their families guaranteed access to a registered nurse 24/7 and risking the health and safety of nursing home residents and workers nationwide.”

Further, it said “Trump and his cronies claim AI nurses can fill the gap, an overtly offensive suggestion to any family who has faced the often-painful decision to seek out care for a loved one in a nursing home.”

Democrats added that “there will always be a need for nursing homes, and for some, they are the preferred setting for care.”

They said families that rely on nursing homes should have the peace of mind that their loved ones will receive quality care, and incentives should reward safe staffing. “Chronic understaffing threatens residents' safety and strains an already underpaid workforce,” the letter said.

Democrats said the Senate Finance Committee under their leadership would seek to:

• Ensure taxpayer dollars are spent on direct care and not siphoned off through profit hiding shell games;

• Align incentives to strengthen nursing home staffing standards so residents are safe and workers are supported; and

• Improve transparency and oversight to ensure facilities consistently meet high quality standards.

Home Care Aid

Besides commenting on nursing homes, the other main pillars of the letter’s LTC overhaul would “Make Home Care Affordable and Accessible” and “Strengthening the Long-Term Care Workforce.”

On home care, Democrats said they will try and advance policies that will:

• Expand access to home care so families in need are not limited by waiting lists, astronomical out-of-pocket costs, or arbitrary poverty thresholds that force families to hand over their hard-earned assets, like their family home, to qualify for services;

• Build on innovative volunteer models that mobilize community members to care for one another;

• Ensure home care is a dependable and integrated part of the healthcare system; and

  Guarantee middle-income families can access care without depleting their savings.

Workforce Aims

The letter said to strengthen the long-term care workforce, Finance Committee staff will develop policies to:

• Improve wages, benefits, training, and career pathways for home care and nursing home workers so these are quality jobs;

• Address workforce shortages by creating training incentives to the greatest extent possible, involving government, employers, and labor unions, to ensure vulnerable seniors and people with disabilities are safely cared for;

• Protect, retain, and attract legal immigrants to fill gaps in the domestic workforce;

• Protect working family caregivers from losing their jobs, savings, and retirement security when a loved one needs support; and

• Ensure caregivers, whether paid or unpaid, are recognized as essential members of the care team.

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.