Senate Finance Committee Democrats released a report Thursday examining nursing home ownership structures, staffing, regulatory oversight, and alleged political influence. While the report does not recommend new federal requirements for assisted living, it comes amid broader congressional scrutiny of long-term care. The report was led by Senators Ron Wyden (D-OR), Sheldon Whitehouse (D-RI), Andy Kim (D-NJ), and Elizabeth Warren (D-MA).
Importantly, the report recognizes assisted living’s distinct regulatory model, noting that it is not federally regulated, is primarily privately financed, and is regulated by the states. That distinction reinforces Argentum’s longstanding position that state-based oversight remains the appropriate framework for assisted living. However, the report’s focus on nursing homes does not mean assisted living will remain outside future legislative or regulatory efforts. Policymakers may apply oversight across the long-term care sector related to ownership, staffing, memory care, and other issues.
Further, the report comes just two weeks after an 81-page Request for Information (RFI) was announced by Senate Finance Committee Democrats examining a potential universal home care benefit, nursing home quality, and the long-term care workforce. The RFI does not propose new federal regulation of assisted living; however, it asks whether a universal home care benefit should cover a broad list of home and community-based services, including through a mandatory Medicaid benefit which expressly includes “assisted living services.” Proposals cited in the RFI would add “nationwide quality oversight and evaluation measures,” a state HCBS ombudsman, and federal standards for direct care pay and training. The RFI also seeks “system-level safeguards” against private equity and other corporate investors in an expanded home care system. Argentum is planning to submit written comments to the RFI in advance of the December 18 deadline.
While no major legislative activity related to this report is expected for the remainder of this Congress, it may still have broader implications for senior living, including congressional interest in ownership and capital structures, memory care, staffing, and long-term care ombudsman programs, and is likely to help shape the oversight and policy agenda for the next Congress. If Democrats gain control of either chamber, they will have greater ability to drive committee oversight, hearings, investigations, and legislation related to long-term care. Senate control could be particularly consequential given the committees and lawmakers that have previously focused on assisted living and broader long-term care policy.
Argentum continues to maintain strong relationships with members of both parties on the relevant congressional committees and will follow up with lawmakers and staff to ensure our message is heard and understood. That includes reinforcing assisted living’s distinct housing and services model, the effectiveness of state-based regulation, and the potential consequences of applying policies developed for other long-term care settings to assisted living. We will coordinate with our State Partners and other stakeholders to ensure that federal policies recognize assisted living’s unique model, preserve state-based regulation, and support access, affordability, and choice for older adults and their families.