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October 31, 2023

House Energy & Commerce Subcommittee holds hearing on long-term care

On October 25, the House Energy and Commerce Committee's Health Subcommittee held a hearing on "Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care." The hearing focused on policies included in two recent Centers for Medicare and Medicaid Services (CMS) proposed rules: the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule and the Ensuring Access to Medicaid Services proposed rule.

Specifically, the discussion focused on the proposed minimum staffing ratios for registered nurses (RNs) and certified nurse aides (CNAs) at long-term care facilities, which would require at least .55 hours per resident day for RNs and 2.45 hours per resident day for CNAs, as well as a requirements to have an RN onsite 24/7, as well as the proposal to require home health agencies to pass through a minimum 80% of all Medicaid payments to the direct workforce (the 80/20 rule), with Republicans speaking in opposition of the rules' top-down mandates and Democrats largely speaking in favor of the Biden administration's effort to address staffing shortages among long-term care facilities and home health agencies. During the hearing, lawmakers heard from a panel of witnesses representing nursing home administrators, home health agency administrators, certified nurse aides, and consumer advocates.

More information is available here.

Additional information is also available in the attached WCEY Alert.


Contact Information
For additional information concerning this Alert, please contact:
Washington Council Ernst & Young
   • Laura Dillon (
   • Heather Meade (


Hearing on long-term care