News and Analysis

In a regulatory overhaul, the Biden administration’s plan to increase staffing in nursing homes is polarizing with fierce lobbying and over 22,000 comments to the Centers for Medicare and Medicaid Services. Questions over affordability and financial transparency exist, as more than 40% of such homes had losses in 2021, but many are suspected of financial manipulation. States would need to track Medicaid spending, but this could lack the necessary transparency. The proposal suggests minimum staffing ratios but falls short of advocates’ demands for staffing sufficient to provide high-quality care.