Today, Gov. Reynolds and Gov. Pillen of Nebraska led a letter, joined by 13 other Republican governors, directing President Joe Biden to reconsider the CMS proposed one-size-fits-all long-term care staffing requirements’ rule that will force many long-term care facilities to close and erode health care access for some of the nation’s most vulnerable citizens. 

The letter reads as: 

“As governors, we are committed to protecting the health and safety of all our citizens, including those in nursing homes in our states. On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) proposed new regulations for long-term care facilities that impose unnecessary, one-size-fits-all staff requirements. If adopted, CMS’s proposed regulations will force many long-term care facilities in our communities to close, eroding access to healthcare for some of our most vulnerable citizens. 


“America’s long-term care industry is facing a full-fledged workforce crisis, hitting lows not seen since 1994. Between February 2020 and December 2022, facilities lost more than 200,000 workers, and industry observers view long-term care as among the hardest hit sectors in healthcare that has still not recovered from the COVID-19 pandemic. Such challenges are especially acute in rural areas. Despite this, the CMS requirements would force over 80% of facilities nationwide to hire more staff at a time when workers, particularly RNs, have never been scarcer. 


“In short, Republican governors are pulling multiple levers to ensure these facilities have the staff they need to care for their vulnerable residents. In contrast, your proposed rule treats this complex, deep-rooted problem as something to be solved with a simple wave of the bureaucratic wand. This is not only unrealistic, but it also threatens to unravel the work we have done, while harming the seniors, elderly, and disabled it’s designed to help. We urge you to reconsider your commitment to unfunded mandates and instead enter into a genuine state-federal dialogue on how best to serve residents of long-term care facilities in our states.” 

Additional signatories include Georgia Governor Brian Kemp, Indiana Governor Eric Holcomb, Mississippi Governor Tate Reeves, Missouri Governor Mike Parson, Montana Governor Greg Gianforte, Nevada Governor Joe Lombardo, New Hampshire Governor Chris Sununu, Oklahoma Governor Kevin Stitt, South Carolina Governor Henry McMaster, South Dakota Governor Kristi Noem, Tennessee Governor Bill Lee, Texas Governor Greg Abbott, and Wyoming Governor Mark Gordon. 

You can find a full copy of the letter here