The head of the nation’s top nursing home advocacy group predicted a federal staffing rule could drop this summer, albeit with changes that could make it more palatable for providers.

The Centers for Medicare & Medicaid Services is currently reviewing more than 46,000 comments on the rule it proposed in September, and more than 18,000 of those came through the American Health Care Association.

“We don’t know if CMS will listen to that and accommodate us,” AHCA President and CEO Mark Parkinson said at an event in February. “My guess is they will do something to count LPNs, which they haven’t done in the proposed rule, and my hope is that they will do something to allow RNs to be met virtually.”

The rule will likely come into play as providers finally begin to make a dent in hiring. As of January, federal data showed the sector down 131,900 workers (better than a 190,000 deficit early in the pandemic). Census is also rebounding, with rates just 1% behind pre-pandemic levels, Parkinson said. He added AHCA would continue to pursue administrative, Congressional and, potentially, legal channels to stop the mandate.