CMS to Provide Temporary Exemptions to Facilities that are Unable to Meet Staffing Requirements

CMS to Provide Temporary Exemptions to Facilities that are Unable to Meet Staffing Requirements
Date: May 15, 2024

A recent analysis found that more than 80% of nursing homes do not meet the requirements presented in CMS’s staffing mandate. Since the mandate was proposed, those in the long-term care industry have expressed many concerns.

CMS Administrator Chiquita Brooks-LaSure recently acknowledged that “… some long-term care facilities, especially in rural communities, continue to see challenges in recruiting and retaining nursing home staff because of local workforce unavailability.” In addressing this common concern among providers, Brooks-LaSure noted that a rollout period would help providers adjust to the requirements. The rollout period would give urban facilities until May 2027 and rural communities until May 2028 to meet the requirements.

In addition to the rollout period, the new rule also incorporates temporary exemptions. Facilities eligible for the exemptions are those with clearly identified recruiting hardships and have made great efforts to hire more staff. Furthermore, a $75 million nursing home recruitment program aims to provide facilities with financial incentives to prioritize hiring. More information on these programs and exemptions is to come.

About 25% of nursing homes are estimated to qualify for the nursing hours exemption. Kristiana Yao, senior policy advisor at CMS, notes that the exemption won’t be granted to anyone. Jonathan Blum, principal deputy administrator and COO at CMS, elaborates. Blum shares that “the core principle here is that we want every facility across the country to make strong efforts to improve their staffing ratios and the quality of care.”

Although the exemptions put pressure on some facilities, there are still rising concerns among providers that the mandate is not reasonable. The Long-Term Care Imperative states, “Given the persistent workforce crisis, which limits our ability to recruit and retain staff, and the astronomical costs of the rule, we are disappointed that CMS didn’t sufficiently moderate the rule despite our advocacy.” The statement highlights the “…potentially devastating and long-lasting impacts, such as nursing homes being forced to close if they cannot meet the new staffing mandates. These closures would affect the ability of vulnerable adults to receive needed care.”

In response, CMS officials emphasized the importance and urgency of changing low staffing and poor-quality care. The mandate should be celebrated as a significant step in the right direction for long-term care. Some consumer advocates believe that even stronger regulations are needed.

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Henreckson, Josh. “Analysis Finds 4 in 5 Nursing Facilities Don’t Meet Staffing Requirements.” McKnight’s Long-Term Care News, 24 Apr. 2024,

Julia Kourpas