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Lankford Works to Protect Rural Seniors’ Access to Care, Halt Damaging Medicare Staffing Rule

OKLAHOMA CITY, OK – Senators James Lankford (R-OK) and Deb Fischer (R-NE), along with their colleagues, introduced the Protecting Rural Seniors’ Access to Care Act. The legislation would prohibit the US Department of Health and Human Services (HHS) Secretary from finalizing a proposed nursing home staffing rule that would hurt facilities in rural areas and could force many to close.

Lankford and Fischer were joined by Senators Roger Marshall (R-KS), Jon Tester (D-MT), Kyrsten Sinema (I-AZ), Joe Manchin (D-WV), Roger Wicker (R-MS), Susan Collins (R-ME), and Angus King (I-ME).

The legislation would also establish an advisory panel on nursing home staffing that includes voices from both urban and rural communities. The panel would submit a report to Congress that analyzes workforce shortages and makes practical recommendations to strengthen the workforce.

“Oklahoma seniors, especially in rural communities, deserve quality, safe health care. CMS has proposed a one-size-fits-all staffing mandate that has significantly threatened the ability for patients to receive post-acute care in rural communities. My colleagues and I are taking all available steps to stop the overreaching staffing mandate from CMS—they are not in our communities and clearly do not adequately understand the problems families and seniors are facing when finding care in rural America,” said Lankford.

“Nursing homes across the country face historic staffing shortages, and nowhere are those challenges more real than in rural states like Nebraska. This mandate from the Centers for Medicare and Medicaid Services would force many facilities to reduce their number of patients or even close their doors for good. My legislation will stop this staffing rule and allow time to find a fairer solution that protects rural facilities across our state,” said Fischer.


On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) proposed a rule that would mandate new minimum staffing standards for long-term care (LTC) facilities. According to CMS, 75 percent of nursing homes would have to increase staffing to comply with the proposed standards. This standard will be even harder to meet in rural areas, which already face historic staffing shortages.

While CMS estimates the cost for this rule is $4 billion, LeadingAge, the association for nonprofit providers of aging services, believes that the CMS proposed budget is significantly underestimated. LeadingAge estimates that the rule’s staffing requirements will cost providers nearly $7 billion in the first year alone.

The House-version of this legislation was introduced by Representative Michelle Fischbach (R-MN) in September.

Lankford also recently led a letter to CMS expressing his concerns about this proposed CMS rule, and was joined by 27 of his Senate colleagues.

Lankford remains a strong advocate for addressing health care access deficiencies in rural Oklahoma and around the nation. Lankford introduced his Rural Hospital Closure Relief Act, which would support financially vulnerable rural hospitals facing risk of closure. Lankford announced a huge win late last year for rural hospital access in Oklahoma and around the nation after the Centers for Medicare and Medicaid Services (CMS) announced its Rural Emergency Hospital (REH) rule. The rule, among other things, redefined a “primary” road for purposes of establishing the distance a hospital must be from another hospital to receive CMS’ Critical Access Hospital (CAH) designation.