In a move that could have significant implications for the nursing home industry, the Senate confirmed Robert F. Kennedy Jr. as the new Secretary of the Department of Health and Human Services (HHS) in a 52-48 vote Thursday morning. While his nomination faced criticism—particularly regarding his knowledge of Medicare and Medicaid—his stance on nursing home staffing regulations has garnered attention from long-term care providers.
Medicaid Cuts on the Horizon?
Kennedy takes the helm of HHS as House Republicans push for major budget reductions, with potential cuts of $1.5 to $2 trillion that could significantly impact Medicaid. Given that Medicaid funds approximately 62% of nursing home residents’ care (according to the Kaiser Family Foundation), any reductions could place additional financial strain on facilities already struggling with rising operational costs.
Sen. Ron Wyden (D-OR), ranking member of the Senate Finance Committee, voiced concerns that Kennedy’s alignment with Republican-led budget reforms could lead to nursing home closures. “When seniors are told to vacate their nursing homes because it no longer accepts Medicaid, Republicans will again regret a vote for Robert Kennedy,” Wyden warned ahead of the confirmation vote.
Kennedy’s Stance on Nursing Home Staffing Mandates
Despite uncertainty surrounding his Medicaid policies, Kennedy has signaled that he may be open to revising the Biden administration’s federal nursing home staffing mandate, a regulation that has drawn pushback from industry leaders. During his Senate Finance Committee hearing, Kennedy acknowledged that the rule, which requires 24/7 staffing by medical professionals, could pose a severe challenge for rural nursing homes.
“These are staffing rules that require 24-hour staffing by medical professionals. Some of the nursing homes in rural areas simply do not have the personnel or the economics to be able to do that,” Kennedy said. “We know that the single greatest driver of high-quality nursing home care is the involvement, the proximity of family members.”
His comments were welcomed by nursing home operators, who argue that the staffing mandate, while well-intentioned, does not account for the ongoing workforce crisis and could lead to unintended closures.
The Role of Mehmet Oz and Industry Uncertainty
Kennedy’s potential reliance on CMS administrator nominee Mehmet Oz, MD, to handle Medicaid and Medicare policies raises further questions about the direction of federal funding for nursing homes. At his own confirmation hearing, Kennedy displayed a lack of familiarity with Medicaid, mistakenly describing it as a fully federal program rather than one with heavy state involvement.
With nursing homes still recovering from pandemic-era financial losses, and the workforce crisis remaining unresolved, the industry is watching closely to see how Kennedy’s tenure will shape regulations, funding, and care delivery.
What’s Next for Nursing Homes?
While Kennedy’s confirmation introduces uncertainty regarding Medicaid funding, his willingness to revisit the federal staffing mandate offers a potential silver lining. Nursing home operators should stay engaged with policymakers and advocacy groups to influence upcoming policy decisions that will directly impact their facilities and residents.
With the landscape shifting, providers should prepare for both the risks and opportunities that Kennedy’s leadership could bring to long-term care.