The Senior Care Policy Briefing covers important long-term care issues by highlighting policy updates, news reports, and academic research.

Read the full Senior Care Policy Briefing below or download here.

May 31, 2024.


  • A federal lawsuit filed by the American Health Care Association (AHCA), Leading Age, the Texas Health Care Association, and three skilled nursing facilities aims to overturn CMS’s nursing home staffing mandate. The plaintiffs argue that the mandate exceeds CMS’s authority and imposes unattainable standards that could harm nursing home residents.
    • In fact, by requiring facilities to meet specific staffing levels, the mandate would help address the chronic understaffing issues that compromise resident safety and well-being, ultimately improving the overall quality of life for nursing home residents and nursing home workers.
    • Unsurprising to resident advocates, plaintiffs brought their case in the US District Court for the Northern District of Texas’s Amarillo Division, a district known for rulings against the Biden administration. This tactic, known as “judge shopping,” allows plaintiffs to effectively select their judges. Despite calls for reform, this practice continues.


  • Over 800,000 Americans reside in assisted living facilities. The lack of federal quality and safety standards, along with the scarcity of reliable public information on quality, safety, and costs, has made the assisted living sector attractive for investment. A recent article found that, given that the majority of assisted living is private pay, “estimated profit margins of 20-40 percent are higher than those of most other health care providers.”
    • Meanwhile, a new report from the US Government Accountability Office finds that the rapid expansion of the assisted living industry is straining state long-term care ombudsman programs, which are struggling to manage increased workloads without additional staffing or resources.


  • A new study reveals that 73% of the nursing home workforce experiences “intermediate to high levels” of stress, with 34% in the high-risk category, double the rate of the general population. Registered nurses showed the highest Adverse Childhood Experiences (ACEs) scores, correlating with increased burnout and turnover exacerbated by the pandemic. The study underscores the urgent need to address benefits for healthcare workers.


The visualization above highlights the retention challenges faced by the long-term care sectors compared to the overall U.S. industry average. One issue is competition from other sectors like retail and food service, which offer similar (low) pay for less demanding work. The emotional and psychological demands of home and nursing home care, combined with the insufficient support systems for direct care workers, make these roles exceptionally challenging.