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AHCA Voices Concerns with Proposed Rule  
AHCA Voices Concerns with Proposed Rule
Arbitration is key issue
(202) 898-3165


Washington, D.C. -- The American Health Care Association (AHCA) today submitted extensive comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule "Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities." The comment period for the 400-plus page rule closes today.

"These proposed regulations will have a deleterious effect on every skilled nursing care center," said Mark Parkinson, President and CEO of AHCA. "CMS is asking for too much too soon and at too great a cost to providers."

The Association is adding its voice to the thousands of others who have submitted comments to tell CMS that the proposed rule will impact critical areas such as staffing and care delivery, particularly given that it is an unfunded mandate.

"We concur with CMS that updating the Requirements of Participation is necessary to reflect current standards of practice," said Parkinson. "And while many of the updates and changes are positive, the proposed regulations are too extensive for quick adoption. If not carefully phased in, the final rule will be disruptive to proper care center operations and will redirect staff and resources away from a continuous pursuit of quality outcomes. AHCA believes that implementation of this proposed rule must occur on a staggered basis over a period of five years." 

Of particular concern to AHCA are the components of the proposed rule that deal with arbitration agreements. Because AHCA strongly opposes CMS's arbitration-related proposals, its arbitration comments were submitted separately to underscore the importance of this issue to the entire long term care profession.

"CMS's arbitration-related proposals should be withdrawn," said Parkinson. "These proposals exceed CMS's statutory authority and are not necessary to protect resident health and safety. In addition, many of the stated factual and legal grounds for the proposals are incorrect. Congress has repeatedly rejected efforts to regulate the use of arbitration agreements by skilled nursing care centers and their residents," he added.

Parkinson noted that cost estimates for implementing the rule are more than $700 million nationwide in the first year alone, or nearly $50,000 per year per care center. With government estimates showing nursing home operating margins at only 1.9 percent, skilled nursing care centers cannot absorb increased administrative and staffing costs.

"How are care centers supposed to pay for this?" Parkinson asked. "Either the federal government should pay or high-cost requirements should be implemented at the back end of a reasonable phase-in period. New requirements often look good on paper, yet only drain scarce funds away from resident care, quality of life activities, staff job creation and salaries."