The Department of Health and Human Services (HHS) is set to roll out a policy that will significantly reduce public participation in its rule-making processes, a move that has sent shockwaves through the nursing home industry. The new policy, slated for publication in the Federal Register on Monday, leverages a “good cause” exception in the Administrative Procedure Act (APA) to bypass traditional notice and comment periods.
HHS Secretary Robert F. Kennedy Jr. defended the decision, stating in an online statement, “The extra-statutory obligations of the Richardson Waiver impose costs on the Department and the public, are contrary to the efficient operation of the Department, and impede the Department’s flexibility to adapt quickly to legal and policy mandates.” This reversal of the 1971 Richardson waiver, which promoted greater public engagement, has raised serious concerns among industry leaders.
Industry Leaders Express Concerns
Katie Smith Sloan, CEO and president of LeadingAge, expressed deep concern about the potential impact on older adults and aging services providers. “The possibility that HHS under the Trump White House will eliminate or significantly scale back public comment on policies impacting payment, regulations, safety, operations, and other critical areas is truly troubling,” she said.
The move comes at a time when the nursing home industry faces numerous challenges, including staffing shortages and regulatory compliance. Public input has historically played a crucial role in shaping effective policies. For example, in 2023, over 46,000 providers, workers, and patient advocates weighed in on the proposed staffing mandate, leading CMS to adjust its hourly standard.
Statistics and Impact
A recent analysis by the Center for Regulatory Solutions found that “HHS accounts for a disproportionately large share of federal regulations, with a significant impact on the healthcare sector, which comprises nearly 20% of the U.S. economy.” This statistic underscores the potential reach and impact of the new HHS policy.
While HHS assures that mandatory public comment periods, such as those for CMS payment rules, will remain, the discretionary application of notice and comment procedures raises questions. The ability to introduce more rules at the final stage could expedite regulatory changes, but it also risks overlooking crucial insights from on-the-ground providers.
What This Means for Nursing Homes
The potential reduction in public participation could have far-reaching implications for nursing homes. Key areas such as payment policies, staffing mandates, and quality of care regulations may be altered with less input from those directly affected.
Providers rely on the ability to provide feedback on proposed rules to ensure they are practical and effective. As Sloan pointed out, “on-the-ground providers offer key insights on proposed rules, a part of the process [that is] vital to creating and revising effective, efficient and practical policy.”
The industry will be closely monitoring the implementation of this new policy, as its impact on the quality of care and operational efficiency remains to be seen.
Key Takeaways:
- HHS plans to reduce public participation in rule-making, citing efficiency.
- Industry leaders express concerns about the potential negative impact on older adults and providers.
- Public input has historically played a crucial role in shaping effective policies.
- The new policy could expedite regulatory changes but risks overlooking crucial insights from providers.