| 1 | 1 | | II |
|---|
| 2 | 2 | | 119THCONGRESS |
|---|
| 3 | 3 | | 1 |
|---|
| 4 | 4 | | STSESSION S. 750 |
|---|
| 5 | 5 | | To prohibit the Secretary of Health and Human Services from implementing, |
|---|
| 6 | 6 | | enforcing, or otherwise giving effect to a final rule regarding minimum |
|---|
| 7 | 7 | | staffing for nursing facilities, and to establish an advisory panel on |
|---|
| 8 | 8 | | the nursing home workforce. |
|---|
| 9 | 9 | | IN THE SENATE OF THE UNITED STATES |
|---|
| 10 | 10 | | FEBRUARY26, 2025 |
|---|
| 11 | 11 | | Mrs. F |
|---|
| 12 | 12 | | ISCHER(for herself and Mr. LANKFORD) introduced the following bill; |
|---|
| 13 | 13 | | which was read twice and referred to the Committee on Finance |
|---|
| 14 | 14 | | A BILL |
|---|
| 15 | 15 | | To prohibit the Secretary of Health and Human Services |
|---|
| 16 | 16 | | from implementing, enforcing, or otherwise giving effect |
|---|
| 17 | 17 | | to a final rule regarding minimum staffing for nursing |
|---|
| 18 | 18 | | facilities, and to establish an advisory panel on the nurs- |
|---|
| 19 | 19 | | ing home workforce. |
|---|
| 20 | 20 | | Be it enacted by the Senate and House of Representa-1 |
|---|
| 21 | 21 | | tives of the United States of America in Congress assembled, 2 |
|---|
| 22 | 22 | | SECTION 1. SHORT TITLE. 3 |
|---|
| 23 | 23 | | This Act may be cited as the ‘‘Protecting Rural Sen-4 |
|---|
| 24 | 24 | | iors’ Access to Care Act’’. 5 |
|---|
| 25 | 25 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S750.IS S750 |
|---|
| 26 | 26 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 |
|---|
| 27 | 27 | | •S 750 IS |
|---|
| 28 | 28 | | SEC. 2. PROHIBITION ON IMPLEMENTING, ENFORCING, OR 1 |
|---|
| 29 | 29 | | OTHERWISE GIVING EFFECT TO THE FINAL 2 |
|---|
| 30 | 30 | | STAFFING RULE. 3 |
|---|
| 31 | 31 | | Beginning on the date of enactment of this Act, the 4 |
|---|
| 32 | 32 | | Secretary of Health and Human Services may not imple-5 |
|---|
| 33 | 33 | | ment, enforce, or otherwise give effect to the final rule 6 |
|---|
| 34 | 34 | | entitled ‘‘Medicare and Medicaid Programs; Minimum 7 |
|---|
| 35 | 35 | | Staffing Standards for Long-Term Care Facilities and 8 |
|---|
| 36 | 36 | | Medicaid Institutional Payment Transparency Reporting’’ 9 |
|---|
| 37 | 37 | | published by the Department of Health and Human Serv-10 |
|---|
| 38 | 38 | | ices on May 10, 2024 (89 Fed. Reg. 40976–41000), and 11 |
|---|
| 39 | 39 | | may not promulgate any substantially similar rule. 12 |
|---|
| 40 | 40 | | SEC. 3. ADVISORY PANEL ON NURSING HOME WORKFORCE. 13 |
|---|
| 41 | 41 | | (a) I |
|---|
| 42 | 42 | | NGENERAL.—Not later than 60 days after the 14 |
|---|
| 43 | 43 | | date of the enactment of this section, the Secretary of 15 |
|---|
| 44 | 44 | | Health and Human Services (in this section referred to 16 |
|---|
| 45 | 45 | | as the ‘‘Secretary’’) shall establish the Advisory Panel on 17 |
|---|
| 46 | 46 | | the Nursing Home Workforce (in this section referred to 18 |
|---|
| 47 | 47 | | as the ‘‘Panel’’). 19 |
|---|
| 48 | 48 | | (b) M |
|---|
| 49 | 49 | | EMBERSHIP.— 20 |
|---|
| 50 | 50 | | (1) N |
|---|
| 51 | 51 | | UMBER AND APPOINTMENT .—The Panel 21 |
|---|
| 52 | 52 | | shall be composed of 17 members representing var-22 |
|---|
| 53 | 53 | | ious geographic areas, appointed by the Secretary as 23 |
|---|
| 54 | 54 | | follows: 24 |
|---|
| 55 | 55 | | (A) 1 representative of the Secretary, who 25 |
|---|
| 56 | 56 | | shall serve as the chair of the Panel. 26 |
|---|
| 57 | 57 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S750.IS S750 |
|---|
| 58 | 58 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 3 |
|---|
| 59 | 59 | | •S 750 IS |
|---|
| 60 | 60 | | (B) 2 registered nurses who actively fur-1 |
|---|
| 61 | 61 | | nish services in a skilled nursing facility or 2 |
|---|
| 62 | 62 | | nursing facility, one of whom shall represent a 3 |
|---|
| 63 | 63 | | rural area. 4 |
|---|
| 64 | 64 | | (C) 2 licensed professional nurses who ac-5 |
|---|
| 65 | 65 | | tively furnish services in a skilled nursing facil-6 |
|---|
| 66 | 66 | | ity or nursing facility, one of whom shall rep-7 |
|---|
| 67 | 67 | | resent a rural area. 8 |
|---|
| 68 | 68 | | (D) 2 nurse aides who actively furnish 9 |
|---|
| 69 | 69 | | services in a skilled nursing facility or nursing 10 |
|---|
| 70 | 70 | | facility, one of whom shall represent a rural 11 |
|---|
| 71 | 71 | | area. 12 |
|---|
| 72 | 72 | | (E) 2 physicians who actively furnish serv-13 |
|---|
| 73 | 73 | | ices in a skilled nursing facility or nursing facil-14 |
|---|
| 74 | 74 | | ity, one of whom shall represent a rural area. 15 |
|---|
| 75 | 75 | | (F) 1 representative of the Centers for 16 |
|---|
| 76 | 76 | | Medicare & Medicaid Services. 17 |
|---|
| 77 | 77 | | (G) 1 representative of the Health Re-18 |
|---|
| 78 | 78 | | sources and Services Administration. 19 |
|---|
| 79 | 79 | | (H) 2 individuals with professional exper-20 |
|---|
| 80 | 80 | | tise related to the nursing home workforce, one 21 |
|---|
| 81 | 81 | | of whom shall have experience with respect to 22 |
|---|
| 82 | 82 | | the nursing home workforce in rural and under-23 |
|---|
| 83 | 83 | | served areas. 24 |
|---|
| 84 | 84 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S750.IS S750 |
|---|
| 85 | 85 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 |
|---|
| 86 | 86 | | •S 750 IS |
|---|
| 87 | 87 | | (I) 1 licensed administrator or representa-1 |
|---|
| 88 | 88 | | tive of a rural not-for-profit skilled nursing fa-2 |
|---|
| 89 | 89 | | cility. 3 |
|---|
| 90 | 90 | | (J) 1 licensed administrator or representa-4 |
|---|
| 91 | 91 | | tive of a rural for-profit skilled nursing facility. 5 |
|---|
| 92 | 92 | | (K) 2 representatives of State boards of 6 |
|---|
| 93 | 93 | | nursing. 7 |
|---|
| 94 | 94 | | (2) T |
|---|
| 95 | 95 | | IMING OF APPOINTMENTS .—Each of the 8 |
|---|
| 96 | 96 | | appointments under paragraph (1) shall be made not 9 |
|---|
| 97 | 97 | | later than 60 days after the date of the enactment 10 |
|---|
| 98 | 98 | | of this section. 11 |
|---|
| 99 | 99 | | (3) T |
|---|
| 100 | 100 | | ERMS; VACANCIES.—Each member shall be 12 |
|---|
| 101 | 101 | | appointed for a term not to exceed 2 years, and a 13 |
|---|
| 102 | 102 | | vacancy in the Panel shall be filled in the manner 14 |
|---|
| 103 | 103 | | in which the original appointment was made. 15 |
|---|
| 104 | 104 | | (4) Q |
|---|
| 105 | 105 | | UORUM.—13 members of the Panel shall 16 |
|---|
| 106 | 106 | | constitute a quorum. 17 |
|---|
| 107 | 107 | | (5) F |
|---|
| 108 | 108 | | EDERAL ADVISORY COMMITTEE ACT .— 18 |
|---|
| 109 | 109 | | Chapter 10 of title 5, United States Code, shall 19 |
|---|
| 110 | 110 | | apply to the Panel. 20 |
|---|
| 111 | 111 | | (c) D |
|---|
| 112 | 112 | | UTIES.— 21 |
|---|
| 113 | 113 | | (1) M |
|---|
| 114 | 114 | | EETINGS.— 22 |
|---|
| 115 | 115 | | (A) F |
|---|
| 116 | 116 | | REQUENCY.—The Panel shall meet 23 |
|---|
| 117 | 117 | | not later than 180 days after the date on which 24 |
|---|
| 118 | 118 | | the appointments described in subsection (b) 25 |
|---|
| 119 | 119 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S750.IS S750 |
|---|
| 120 | 120 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 |
|---|
| 121 | 121 | | •S 750 IS |
|---|
| 122 | 122 | | are made, and not less frequently than twice 1 |
|---|
| 123 | 123 | | per year thereafter. 2 |
|---|
| 124 | 124 | | (B) P |
|---|
| 125 | 125 | | UBLIC ACCESS.—The Panel shall 3 |
|---|
| 126 | 126 | | make available on a public website of the De-4 |
|---|
| 127 | 127 | | partment of Health and Human Services— 5 |
|---|
| 128 | 128 | | (i) real-time virtual access to each 6 |
|---|
| 129 | 129 | | meeting of the Panel; and 7 |
|---|
| 130 | 130 | | (ii) not later than 30 days after each 8 |
|---|
| 131 | 131 | | such meeting, a recording and transcript of 9 |
|---|
| 132 | 132 | | the meeting. 10 |
|---|
| 133 | 133 | | (2) R |
|---|
| 134 | 134 | | EPORTS.— 11 |
|---|
| 135 | 135 | | (A) I |
|---|
| 136 | 136 | | NITIAL REPORT.—Not later than 60 12 |
|---|
| 137 | 137 | | days after the initial meeting of the Panel 13 |
|---|
| 138 | 138 | | under paragraph (1)(A), the Panel shall submit 14 |
|---|
| 139 | 139 | | to the Secretary, the Committee on Ways and 15 |
|---|
| 140 | 140 | | Means and the Committee on Energy and Com-16 |
|---|
| 141 | 141 | | merce of the House of Representatives, and the 17 |
|---|
| 142 | 142 | | Committee on Finance of the Senate, and shall 18 |
|---|
| 143 | 143 | | publish on a public website of the Centers for 19 |
|---|
| 144 | 144 | | Medicare & Medicaid Services, a report on the 20 |
|---|
| 145 | 145 | | state of the nursing home workforce, which 21 |
|---|
| 146 | 146 | | shall include— 22 |
|---|
| 147 | 147 | | (i) an assessment of the state of the 23 |
|---|
| 148 | 148 | | nursing home workforce in rural and un-24 |
|---|
| 149 | 149 | | derserved areas, including an analysis of— 25 |
|---|
| 150 | 150 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S750.IS S750 |
|---|
| 151 | 151 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 6 |
|---|
| 152 | 152 | | •S 750 IS |
|---|
| 153 | 153 | | (I) workforce shortages; and 1 |
|---|
| 154 | 154 | | (II) with respect to individuals 2 |
|---|
| 155 | 155 | | entitled to benefits under part A of 3 |
|---|
| 156 | 156 | | title XVIII of the Social Security Act 4 |
|---|
| 157 | 157 | | (42 U.S.C. 1395 et seq.) and individ-5 |
|---|
| 158 | 158 | | uals entitled to medical assistance 6 |
|---|
| 159 | 159 | | under title XIX of such Act (42 7 |
|---|
| 160 | 160 | | U.S.C. 1396 et seq.), barriers to ac-8 |
|---|
| 161 | 161 | | cess to skilled nursing facilities and 9 |
|---|
| 162 | 162 | | nursing facilities caused by such 10 |
|---|
| 163 | 163 | | shortages; 11 |
|---|
| 164 | 164 | | (ii) an analysis of regulations, sub- 12 |
|---|
| 165 | 165 | | regulatory guidance, and guidance to State 13 |
|---|
| 166 | 166 | | survey agencies issued by the Secretary 14 |
|---|
| 167 | 167 | | with respect to skilled nursing facilities 15 |
|---|
| 168 | 168 | | and nursing facilities, and the effects of 16 |
|---|
| 169 | 169 | | such regulations and guidance on the nurs-17 |
|---|
| 170 | 170 | | ing home workforce; 18 |
|---|
| 171 | 171 | | (iii) recommendations for the Sec-19 |
|---|
| 172 | 172 | | retary to strengthen the nursing home 20 |
|---|
| 173 | 173 | | workforce, including recommendations for 21 |
|---|
| 174 | 174 | | decreasing regulatory burdens for skilled 22 |
|---|
| 175 | 175 | | nursing facilities and nursing facilities and 23 |
|---|
| 176 | 176 | | making financial investments in training 24 |
|---|
| 177 | 177 | | for health professionals; and 25 |
|---|
| 178 | 178 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S750.IS S750 |
|---|
| 179 | 179 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 7 |
|---|
| 180 | 180 | | •S 750 IS |
|---|
| 181 | 181 | | (iv) other information as the Panel 1 |
|---|
| 182 | 182 | | determines necessary. 2 |
|---|
| 183 | 183 | | (B) S |
|---|
| 184 | 184 | | UBSEQUENT REPORTS .—Not later 3 |
|---|
| 185 | 185 | | than 1 year after submitting the initial report 4 |
|---|
| 186 | 186 | | under subparagraph (A), and annually there-5 |
|---|
| 187 | 187 | | after, the Panel shall submit and publish an up-6 |
|---|
| 188 | 188 | | dated report in the same manner as required 7 |
|---|
| 189 | 189 | | under such subparagraph. 8 |
|---|
| 190 | 190 | | (d) D |
|---|
| 191 | 191 | | EFINITIONS.—In this section, the following defi-9 |
|---|
| 192 | 192 | | nitions apply: 10 |
|---|
| 193 | 193 | | (1) N |
|---|
| 194 | 194 | | URSING FACILITY.—The term ‘‘nursing 11 |
|---|
| 195 | 195 | | facility’’ has the meaning given such term in section 12 |
|---|
| 196 | 196 | | 1919(a) of the Social Security Act (42 U.S.C. 13 |
|---|
| 197 | 197 | | 1396r(a)). 14 |
|---|
| 198 | 198 | | (2) N |
|---|
| 199 | 199 | | URSING HOME WORKFORCE .—The term 15 |
|---|
| 200 | 200 | | ‘‘nursing home workforce’’ means the workforce of 16 |
|---|
| 201 | 201 | | health professionals that provide direct resident care 17 |
|---|
| 202 | 202 | | in skilled nursing facilities and nursing facilities. 18 |
|---|
| 203 | 203 | | (3) R |
|---|
| 204 | 204 | | URAL AREA.—The term ‘‘rural area’’ 19 |
|---|
| 205 | 205 | | means any area outside a metropolitan statistical 20 |
|---|
| 206 | 206 | | area. 21 |
|---|
| 207 | 207 | | (4) S |
|---|
| 208 | 208 | | KILLED NURSING FACILITY .—The term 22 |
|---|
| 209 | 209 | | ‘‘skilled nursing facility’’ has the meaning given such 23 |
|---|
| 210 | 210 | | term in section 1819(a) of the Social Security Act 24 |
|---|
| 211 | 211 | | (42 U.S.C. 1395i–3(a)). 25 |
|---|
| 212 | 212 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S750.IS S750 |
|---|
| 213 | 213 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 8 |
|---|
| 214 | 214 | | •S 750 IS |
|---|
| 215 | 215 | | (5) UNDERSERVED AREA .—The term ‘‘under-1 |
|---|
| 216 | 216 | | served area’’ means an area that is— 2 |
|---|
| 217 | 217 | | (A) a health professional shortage area, as 3 |
|---|
| 218 | 218 | | such term is defined in section 332(a)(1)(A) of 4 |
|---|
| 219 | 219 | | the Public Health Service Act (42 U.S.C. 5 |
|---|
| 220 | 220 | | 254e(a)(1)(A)); or 6 |
|---|
| 221 | 221 | | (B) designated as a medically underserved 7 |
|---|
| 222 | 222 | | area pursuant to section 330(b)(3)(A) of such 8 |
|---|
| 223 | 223 | | Act (42 U.S.C. 254b(b)(3)(A)). 9 |
|---|
| 224 | 224 | | Æ |
|---|
| 225 | 225 | | VerDate Sep 11 2014 23:13 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\S750.IS S750 |
|---|
| 226 | 226 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB |
|---|