A bill that many providers view as the best bet to upend the federal nursing home staffing mandate finalized last week will get another hearing in Congress Tuesday.

The House Energy and Commerce Committee will review the Protecting Seniors Access to Care Act, as well as several other long-term care and workforce-related bills, during a 10 a.m. session. 

The legislation prevents the Centers for Medicare & Medicaid Services from implementing or enforcing its newly issued minimum staffing requirements, including 3.48 hours of direct care per patient per day and a rule mandating a registered nurse be on-site 24 hours a day. The first provision of the rule, calling for all nursing homes in the US to update their facility assessment, kicks in on Aug. 10, while the staffing provisions come into play over the next two to five years.

After CMS dropped its finalized rule last week — with no additional funding needed to hire thousands of workers — providers’ quest for a fix has only attracted more interest.

“The long-term care profession is at a pivotal moment as providers face an impossible mandate from Washington. We are hopeful that the members of the House Energy and Commerce Committee will use this hearing as an opportunity to consider the reality of what’s ahead for long-term care providers and the millions of Americans who turn to nursing homes for the care they need and deserve,” Clif Porter, senior vice president of Government Relations for the American Health Care Association/National Center for Assisted Living told McKnight’s Long-Term Care News Friday.

“To that end, we encourage this committee to formally advance Representatives Fischbach and Pence’s policy, Protecting America’s Seniors Access to Care Act, to stop the unfunded, unrealistic staffing mandate,” he added.

After the rule’s release, House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA), pictured, said the rule would result in reduced access to care “for those that need it most.”

 “The President’s one-size-fits-all, Washington-knows-best approach to long-term care is an unfunded mandate that will drive up costs and threaten access for patients,” she said. “The minimum staff-to-patient ratio is unworkable for nearly 80 percent of nursing homes, requiring facilities to increase costs for patients or close their doors to new patients.”

The also powerful House Ways and Means Committee already advanced the bill out of committee in early March, and the bill has a companion working its way through the Senate.

But given the bipartisan divide in Congress, and Democrats’ hold on the Senate, provider groups are not pinning their hopes on a single legislative solution.

Multi-front attack against rule

Several attempts to thwart the staffing mandate are moving forward simultaneously, with advocates eyeing major workforce solutions and looking for elected officials willing to champion use of a lawmaking strategy rarely deployed mid-term.

Using the Congressional Review Act (CRA), legislators can vote to revoke policy made by administrative agencies. It’s more typically used after a federal election, when a new president and Congress have 60 legislative days to erase a rule passed late in the previous administration.

But the act also can be triggered by a sitting Congress. A disapproval in both houses would have to be followed by the signature of President Biden, who has made the staffing rule a cornerstone of his caregiving agenda, or a super-majority vote to override a veto.

Todd Adams, director of Health Legislative Affairs for LeadingAge, told McKnight’s his organization is “engaging with House and Senate offices that are interested in pursuing a CRA resolution of disapproval for the minimum staffing rule.”

That work can begin in earnest once the rule is formally published in the Federal Register, which is currently set for May 10.

Meanwhile, both LeadingAge and AHCA are working to gather more support for federal legislation that could give the sector a boost, whether a staffing mandate comes into being or not.

“We commend the Members of Congress who have developed smart, thoughtful policies that offer support, resources, and innovative solutions to solving the long-term care workforce crisis, such as the Building America’s Health Care Workforce Act [expanding TNA training terms] from Representatives Guthrie and Dean and the Ensuring Seniors’ Access to Quality Care Act [addressing CNA training lock-outs] from Representatives Estes and Connolly,” Porter said.

Both of those bills will also be discussed at the hearing Tuesday.