LeadingAge has formally asked the incoming presidential team to repeal the federal nursing home staffing mandate adopted by the Biden White House.

“The staffing mandate, we are expecting it to be repealed, and we are asking the administration to repeal the staffing mandate,” said Janine Finck-Boyle, vice president of health policy and regulatory affairs for LeadingAge. “We have moved definitely in advocacy, and we’re looking at, hopefully, that will be what will happen.” 

Those efforts come as LeadingAge and the American Health Care Association near a potential January ruling in their case challenging the staffing rule in federal court.

Finck-Boyle and Jodi Eyigor, LeadingAge director of nursing home quality and policy, joined McKnight’s Long-Term Care News Senior Editor Thursday to discuss the latest regulatory, payment and policy considerations affecting nursing homes on the cusp of 2025.

While providers could score wins related to regulatory rollbacks and burden reduction efforts in a second Trump presidency, other initiatives are likely to continue regardless of who controls the White House or Congress.

“I think it’s important to be based in reality,” said Eyigor. “We do expect they will be picking up that mantle again … But it’s also important to remember that the job remains the same. We’re still going to be taking care of residents, every day, day in and day out, and we’re still going to need to do certain things, like documenting that care, having good coordination with other care providers.”

Emergency preparedness, for instance, is a long-standing focus, and even the first Trump administration had proposed some infection control changes. Payment also remains a huge, highly variable issue for providers — with plenty of questions swirling around the future of entitlement programs that fund most nursing home care.

Other topics covered in this wide-ranging episode include ongoing concerns with new ownership transparency requirements; provider response to the so-far limited use of shorter, risk-based nursing home surveys, and how the Centers for Disease Control and Prevention’s role in nursing homes could be reshaped by new leadership.

Listen is as Eyigor and Finck-Boyle highlight key challenges to prepare for and possible opportunities providers may be able to seize upon in 2025.

Julie Ward, senior executive officer of public policy for The Arc, feels a strong sense of urgency to help protect the Medicaid program and its home- and community-based services (HCBS) from impending cuts. For people with disabilities, she noted, HCBS is a lifeline. If HCBS is cut, it will force people into institutions and cause hardships for families. The HCBS program is currently grappling with challenges including a waiting list of over 711,000 and a workforce shortage. Procedural challenges that ensued with the Medicaid unwinding — the process of refining Medicaid enrollment following the COVID-19 pandemic — may serve as a cautionary tale if the Trump administration enacts work requirements, she said. The need to act to defend Medicaid feels stronger than it ever has been, she noted, as there will not be a divided Congress to serve as a backstop.

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Thanks to monitoring technology, Griswold has learned just how often clients fall when caregivers are not in the home, CEO Michael Slupecki said. This technology also has helped to provide insights into whether caregivers and patients are getting along and whether patients are confused about their medications. This type of data not only helps to improve the experience for patients, it also provides key data for insurance payers like Medicare Advantage. As the number of people aging in place grows and caregiver shortages worsen, AI will help to manage limited resources, he said.

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