[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3410 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 3410
To prohibit the Secretary of Health and Human Services from finalizing
a proposed rule regarding minimum staffing for nursing facilities, and
to establish an advisory panel on the nursing home workforce.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 5, 2023
Mrs. Fischer (for herself, Mr. Tester, Mr. Marshall, Mr. Lankford, Mr.
Manchin, Ms. Sinema, Mr. Wicker, Ms. Collins, and Mr. King) introduced
the following bill; which was read twice and referred to the Committee
on Finance
_______________________________________________________________________
A BILL
To prohibit the Secretary of Health and Human Services from finalizing
a proposed rule regarding minimum staffing for nursing facilities, and
to establish an advisory panel on the nursing home workforce.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protecting Rural Seniors' Access to
Care Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) According to the Bureau of Labor Statistics, between
February 2020 and August 2023, nursing homes in the United
States lost nearly 200,000 employees.
(2) Forty-five percent of nursing home providers have
reported a worsening workforce situation since May 2022.
(3) Ninety-six percent of nursing home providers have
reported difficulty in hiring staff.
(4) More than ninety percent of nursing home providers have
increased wages and bonuses to recruit and retain staff.
(5) Nearly eighty percent of nursing home providers have
hired temporary staff, who are often much more expensive than
permanent staff.
(6) The Centers for Medicare & Medicaid Services reported
that 129 nursing homes closed in 2022, threatening access for
America's seniors, especially in rural areas.
(7) The minimum staffing mandate in the proposed rule
entitled ``Medicare and Medicaid Programs; Minimum Staffing
Standards for Long-Term Care Facilities and Medicaid
Institutional Payment Transparency Reporting'' published by the
Department of Health and Human Services on September 6, 2023
(88 Fed. Reg. 61352-61429), will result in nursing home
closures, displacing an estimated 450,000 nursing home
residents, harming access to nursing home care, especially in
rural areas (as defined in the proposed rule).
(8) The minimum staffing mandate in the proposed rule may
exacerbate workforce shortages, especially in rural areas (as
defined in the rule).
SEC. 3. PROHIBITION ON FINALIZING PROPOSED STAFFING RULE.
The Secretary of Health and Human Services may not implement,
enforce, or otherwise give effect to the proposed rule entitled
``Medicare and Medicaid Programs; Minimum Staffing Standards for Long-
Term Care Facilities and Medicaid Institutional Payment Transparency
Reporting'' published by the Department of Health and Human Services on
September 6, 2023 (88 Fed. Reg. 61352-61429), and may not promulgate
any substantially similar rule.
SEC. 4. ADVISORY PANEL ON NURSING HOME WORKFORCE.
(a) In General.--Not later than 60 days after the date of the
enactment of this section, the Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') shall establish the
Advisory Panel on the Nursing Home Workforce (in this section referred
to as the ``Panel'').
(b) Membership.--
(1) Number and appointment.--The Panel shall be composed of
17 members representing various geographic areas, appointed by
the Secretary as follows:
(A) 1 representative of the Secretary, who shall
serve as the chair of the Panel.
(B) 2 registered nurses who actively furnish
services in a skilled nursing facility or nursing
facility, one of whom shall represent a rural area.
(C) 2 licensed professional nurses who actively
furnish services in a skilled nursing facility or
nursing facility, one of whom shall represent a rural
area.
(D) 2 nurse aides who actively furnish services in
a skilled nursing facility or nursing facility, one of
whom shall represent a rural area.
(E) 2 physicians who actively furnish services in a
skilled nursing facility or nursing facility, one of
whom shall represent a rural area.
(F) 1 representative of the Centers for Medicare &
Medicaid Services.
(G) 1 representative of the Health Resources and
Services Administration.
(H) 2 individuals with professional expertise
related to the nursing home workforce, one of whom
shall have experience with respect to the nursing home
workforce in rural and underserved areas.
(I) 1 licensed administrator or representative of a
rural not-for-profit skilled nursing facility.
(J) 1 licensed administrator or representative of a
rural for-profit skilled nursing facility.
(K) 2 representatives of State boards of nursing.
(2) Timing of appointments.--Each of the appointments under
paragraph (1) shall be made not later than 60 days after the
date of the enactment of this section.
(3) Terms; vacancies.--Each member shall be appointed for a
term not to exceed 2 years, and a vacancy in the Panel shall be
filled in the manner in which the original appointment was
made.
(4) Quorum.--13 members of the Panel shall constitute a
quorum.
(5) Federal advisory committee act.--Chapter 10 of title 5,
United States Code, shall apply to the Panel.
(c) Duties.--
(1) Meetings.--
(A) Frequency.--The Panel shall meet not later than
180 days after the date on which the appointments
described in subsection (b) are made, and not less
frequently than twice per year thereafter.
(B) Public access.--The Panel shall make available
on a public website of the Department of Health and
Human Services--
(i) real-time virtual access to each
meeting of the Panel; and
(ii) not later than 30 days after each such
meeting, a recording and transcript of the
meeting.
(2) Reports.--
(A) Initial report.--Not later than 60 days after
the initial meeting of the Panel under paragraph
(1)(A), the Panel shall submit to the Secretary, the
Committee on Ways and Means and the Committee on Energy
and Commerce of the House of Representatives, and the
Committee on Finance of the Senate, and shall publish
on a public website of the Centers for Medicare &
Medicaid Services, a report on the state of the nursing
home workforce, which shall include--
(i) an assessment of the state of the
nursing home workforce in rural and underserved
areas, including an analysis of--
(I) workforce shortages; and
(II) with respect to individuals
entitled to benefits under part A of
title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.) and
individuals entitled to medical
assistance under title XIX of such Act
(42 U.S.C. 1396 et seq.), barriers to
access to skilled nursing facilities
and nursing facilities caused by such
shortages;
(ii) an analysis of regulations, sub-
regulatory guidance, and guidance to State
survey agencies issued by the Secretary with
respect to skilled nursing facilities and
nursing facilities, and the effects of such
regulations and guidance on the nursing home
workforce;
(iii) recommendations for the Secretary to
strengthen the nursing home workforce,
including recommendations for decreasing
regulatory burdens for skilled nursing
facilities and nursing facilities and making
financial investments in training for health
professionals; and
(iv) other information as the Panel
determines necessary.
(B) Subsequent reports.--Not later than 1 year
after submitting the initial report under subparagraph
(A), and annually thereafter, the Panel shall submit
and publish an updated report in the same manner as
required under such subparagraph.
(d) Definitions.--In this section, the following definitions apply:
(1) Nursing facility.--The term ``nursing facility'' has
the meaning given such term in section 1919(a) of the Social
Security Act (42 U.S.C. 1396r(a)).
(2) Nursing home workforce.--The term ``nursing home
workforce'' means the workforce of health professionals that
provide direct resident care in skilled nursing facilities and
nursing facilities.
(3) Rural area.--The term ``rural area'' means any area
outside a metropolitan statistical area.
(4) Skilled nursing facility.--The term ``skilled nursing
facility'' has the meaning given such term in section 1819(a)
of the Social Security Act (42 U.S.C. 1395i-3(a)).
(5) Underserved area.--The term ``underserved area'' means
an area that is--
(A) a health professional shortage area, as such
term is defined in section 332(a)(1)(A) of the Public
Health Service Act (42 U.S.C. 254e(a)(1)(A)); or
(B) designated as a medically underserved area
pursuant to section 330(b)(3)(A) of such Act (42 U.S.C.
254b(b)(3)(A)).
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