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Last month, to avoid impacting access to care in rural and tribal communities, the U.S. Department of Health and Human Services (HHS) repealed key provisions of the minimum staffing standards for long-term care (LTC) facilities.
The provisions set minimum nurse-aide and registered-nurse hours of care per resident per day as part of the Minimum Staffing Standards for LTC Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule.
Tribal communities had previously shared concerns about their ability to comply with the minimum staffing provisions, given Indian Country’s unique funding and staffing challenges. During the open comment period prior to the rule’s release, CMS’s Tribal Technical Advisory Group wrote (PDF, 221 KB, 9 pp):
“Tribal long-term care facilities receive no funding from the Indian Health Service (IHS) and are nearly entirely dependent on Medicare and Medicaid funding to operate. As a result, if proposed staffing standards like these are too expensive or not possible to meet due to staffing shortages, tribal LTC facilities will simply cease to exist, and there will be no more long-term care in our communities.”
HHS is taking steps to ensure future policymaking includes robust tribal consultation.
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