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US Senate Special Committee on Aging holds its First Hearing on Menopause

Published in RINewsToday on September 21, 2026

For generations, menopause was a health issue that many women were expected to deal with on their own, quietly. Last week, the U.S. Senate Special Committee on Aging took the issue into the public discussion, holding the first congressional hearing devoted exclusively to menopause.

The Sept. 16 hearing brought congressional attention to an issue affecting millions of American women navigating perimenopause, menopause and post-menopause. Approximately 2 million more women enter menopause each year.

Menopause affects women differently, but the symptoms can upend daily life. Women may experience hot flashes, vaginal dryness, insomnia, migraine headaches, brain fog, heart palpitations, mood changes, and changes in metabolism. For some, these symptoms become debilitating, disrupting daily and work routines and quality of life.

Senate Aging Committee Chairman Rick Scott (R-FL) and Ranking Member Kirsten Gillibrand (D-NY) convened the hearing, titled “Half the Country, Zero Hearings: Meeting the Moment to End the Menopause Care Gap in America,” to examine what lawmakers call the nation’s “menopause care gap.”

Medical experts, researchers, and women’s health advocates testified about the lack of research, physician training, and access to treatment.

The Senate Aging Committee hearing was a critical step in elevating this issue to determine what’s needed to improve medical research, training, and care for women experiencing menopause,” said Gillibrand in her opening statement.

“Menopause affects half of the population. For generations, women have been told to suffer in silence. I’m done with this silence,” she said.

Even though women in midlife make up a significant portion of the U.S. population, Gillibrand called menopause “one of the most under-researched, undertreated, and under-discussed” health issues in the nation. She pointed to estimates that less than 1% of federal women’s health research funding goes to menopause.

Gillibrand also noted that about 80% of OB-GYN residents report feeling ill-prepared to discuss menopause or its symptoms. The result, she said, is that many women seeking medical care are left without adequate treatment.

Menopause care also carries an economic cost. Gillibrand cited a Mayo Clinic study estimating that menopause costs the U.S. economy $26.6 billion annually, including $1.8 billion in lost work time.

“There’s simply no excuse for the lack of resources and information to help every woman navigate menopause and the challenges that come with it,” said Scott in his opening statement.

Scott cautioned that there is no “one-size-fits-all solution.” Instead, he called for women to have access to reliable information, qualified health care providers, and treatment options that allow them to make informed decisions about their health.

Scott also pointed to hormone replacement therapy as a safe treatment option for many women, while noting that lack of education and access can make it difficult for women to obtain appropriate treatment.

“We also need providers who have the most up-to-date training and who can clearly discuss treatment options with their patients,” said Scott, pointing to the shortage of health care providers as another barrier to care.

Scott and Gillibrand also announced that they sent a bipartisan letter requesting the Government Accountability Office to examine how the federal government both coordinates and funds menopause research and care. The senators say the report could help identify remaining gaps in research, education and treatment.

More Research Needed

Federal funding for research advancing menopause care is inadequate, Dr. Jean Wactawski-Wende, a SUNY Distinguished Professor who has conducted women’s health research for more than four decades, charged.

“In 1985, the National Institutes of Health put forward a study…the report said we’re not doing enough research on women…I’d argue we are now 35 years later, and we have not come all that far,” she told the committee.

“Clinical trials are the gold standard of evidence, and we do not have enough of those trials in women, especially in postmenopausal women,” added Wactawski-Wende.

She identified four areas needing greater attention: increased federal research on women’s health throughout the lifespan; chronic disease in aging women; better education and clinical care after menopause; and greater attention to healthy behaviors throughout life.

Dr. Lynne M. Coslett-Charlton, a board-certified gynecologist who has practiced in Northeastern Pennsylvania for 27 years, pointed to the U.S. Food and Drug Administration’s recent changes to warning labels for menopausal hormone therapy as a major shift in women’s treatment.

Coslett-Charlton also voiced concern that women might get menopause advice from social media influencers instead of from qualified clinicians. This could, in turn, lead them to buy unregulated supplements and products.

She noted that the American College of Obstetricians and Gynecologists has increased its educational efforts to steer patients toward safe, evidence-based, and medically appropriate care. Coslett-Charlton and ACOG also support passage of the Advancing Menopause Care and Midlife Women’s Health Act.

Training Doctors to Treat Menopause

Jennifer Weiss-Wolf, executive director of NYU Law’s Birnbaum Women’s Leadership Center, urged Congress to make telehealth part of the solution. She told lawmakers that virtual care could help connect women, particularly those in areas without specialists, to providers knowledgeable about menopause.

But telehealth has its own barriers, she cautioned, including poor internet connectivity and inadequate insurance coverage. Weiss-Wolf also warned that physician education about menopause must improve.

“For those who started residency after 2002 — statistically that amounts to more than half of all practicing OB-GYNs in the U.S. today — the majority have not had meaningful or even any menopause training,” she said.

Weiss-Wolf called for modern clinical trials that include millennial and Gen X women, with racial, ethnic and geographic diversity. She also urged researchers to use technology better to collect data and track symptoms.

She called on lawmakers to pass three federal bills to increase research and attention to women’s health: the Advancing Menopause Care and Midlife Women’s Health Act; the Service Women and Veterans Menopause Research Act; and the Hormone Health Data and Research Act.

“I Want to Feel Like Myself Again”

“When I ask patients what they hope to get from their care, I often hear, ‘I want to feel like myself again,’” said Dr. Suzanne Silverman Fenske, an obstetrician-gynecologist and integrative medicine practitioner who has practiced in New York City for nearly two decades.

“They want their energy back, relief from anxiety, and a sense of control over a body that suddenly feels unfamiliar,” she said, adding that she

Fenske told the Senate panel that before menopause, a woman’s risk of chronic disease is generally lower than a man’s. After menopause, that risk increases. She pointed to heart disease, hip fractures and urinary sepsis among the serious health problems facing older women.

Fenske also raised an issue that receives far less attention — how physicians are reimbursed for treating menopausal women.

“There is not much incentive for physicians to take care of menopausal women,” she told lawmakers.

Fenske said low insurance reimbursement makes it difficult for independent physicians to spend the necessary time with menopause patients. Large hospital networks may be better able to absorb those costs, she said, while smaller independent practices cannot.

Like the other witnesses, Fenske highlighted the lack of minimum standards for menopause education in medical residency programs.

Fenske offered lawmakers a striking comparison: OB-GYN residents are required to complete at least 200 vaginal deliveries, but there is no comparable minimum requirement for menopause education.  She called on Congress to push Medicare and the Departments of War and Veterans Affairs to make menopause education part of accreditation standards.

Black Box Warning Changes and Challenges

Menopause treatment has received renewed federal attention under Health and Human Services Secretary Robert F. Kennedy Jr., who announced in November 2025 that the FDA would begin removing its strongest “black box” warnings about cardiovascular disease, breast cancer and probable dementia from hormone replacement therapies, including estrogen. The first six revised labels were approved in February 2026, reflecting the administration’s position that overly broad warnings had discouraged women from seeking effective symptom relief. The change does not mean hormone therapy is risk-free: treatment remains an individual decision, with the FDA emphasizing initiation of systemic therapy before age 60 or within 10 years of menopause. The boxed warning about endometrial cancer remains for systemic estrogen-only products. On September 3, the FDA said it was working with manufacturers to increase estrogen patch supplies after rising demand made them harder to find.

Rhode Island No. 1 in U.S. Menopause Workplace Protections

On June 24, 2025, Gov. Dan McKee signed into law legislation (S 0361), introduced by Sen. Lori Urso (D-Dist. 8, Pawtucket), to support women experiencing menopause under the state’s fair employment statute—making Rhode Island the first state to enact such workplace protections explicitly. Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls) introduced a companion bill (H 6161), which passed by concurrence.

Rhode Island law already prohibits workplace discrimination based on pregnancy, childbirth, and related conditions. This includes requiring employers to provide reasonable accommodations and protecting individuals from being denied employment opportunities or promotions—or terminated—because of these conditions. The new law adds menopause to this list of protected health conditions.

“Menopause is a difficult and personal subject that has been stigmatized in this country,” said Sen. Urso in a statement announcing the bill’s passage. “But as something that affects half our population, it’s time we recognize it as a workforce issue—especially as our workforce ages along with our population. The current lack of protections contributes to inadequate retirement savings and lost leadership opportunities for women and poses an economic challenge for employers facing workforce shortages and the loss of experienced employees,” she says.

“Menopause is not something women choose to experience, and its effects on the mind and body can significantly impact daily life and job performance,” said Rep. Alzate. “Women should not have to risk being penalized or discriminated against at work due to a naturally occurring biological transition,” she says.

Rhode Island’s new law is paving the way for workplaces that actually support women experiencing menopause—and it sets a great example for the rest of the country to follow.

A Final Note…

For the millions of women now going through menopause — and the millions more who will follow them — the Sept. 16 hearing put an issue long discussed quietly in doctors’ offices and among women themselves squarely before Congress.

Whether the hearing ultimately results in more federal research, better physician training, and improved access to care will depend on what lawmakers do next. But after generations of silence, menopause finally received its first congressional hearing.

To read Scott and Gillibrand’s correspondence to GAO on the federal government’s role in Menopause research and education, go to Gillibrand Scott GAO Letter on Menopause

To watch the Sept. 16 Senate Aging Committee hearing, go to Half the Country, Zero Hearings: Meeting… | Senate Committee On Aging.

To read about RI’s new Menopause law, go to Rhode Island First in Nation to Add Workplace Protections for Women Experiencing Menopause – Herb Weiss

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Bipartisan efforts strengthens the Dementia public health infrastructure

Published in RINewsToday on December 2, 2024

In the waning days of the Biden administration, Congress has moved one step closer to assisting states to continue to effectively implement dementia interventions.  Following passage of H. R. 7218 on Sept. 17th, by voice vote on Nov. 21st, the U.S. Senate passed S. 3775, also without objection. At press time, the bipartisan legislation now heads to President Biden’s desk to be signed into law.

Once signed, the new law re-authorizes the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L.115-406) enacted in 2018, empowering public health departments across the country to implement effective dementia interventions in their communities.

In a March 2024 fact sheet, the Alzheimer’s Impact Movement (AIM) calls for Alzheimer’s and other dementias to be considered an urgent public health issue, noting that nearly 7 million seniors across the nation are currently living with Alzheimer’s.

While partisan bickering has reduced the number of bills passed during the 118th Congress, Democratic and Republican lawmakers seek solutions for containing the skyrocketing costs of care, finding a cure for debilitating brain disorders, and supporting caregivers. 

The nation spends more than $360 billion per year, including $231 billion in costs to Medicare and Medicaid. Barring any major breakthroughs to prevent, slow down, or cure Alzheimer’s, the number of Americans with Alzheimer’s is expected to double by 2060, costing the nation more than $1.1 trillion per year, says AIM’s Fact Sheet.

Congress continues funding of Dementia effective interventions

In the Senate, S. 3775 was spearheaded by Sens. Susan Collins (R-ME) Catherine Cortez Masto (D-NV), Tim Kaine (D-VA), and Shelley Moore Capito (R-WV), and cosponsored by Sens. Jack Reed and Sheldon Whitehouse.  It’s companion measure, H.R. 7218, was introduced in the House by Reps. Brett Guthrie (R-KY), Chairman of the Health Subcommittee of the House Energy & Commerce Committee, along with Chris Smith (R-NJ), Paul Tonko (D-NY), and Maxine Waters (D-CA).

With its enactment in 2018, P.L. 115-406 accelerated a multi-pronged public health approach to reduce risk, detect early symptoms, advance care, improve data, and ultimately change the trajectory of this devastating disease.

Headed by the Centers for Disease and Prevention (CDC), the reauthorization would authorize $33 million per year, in line with current appropriations, over the next five years to support:

1.  Alzheimer’s Disease and Related Dementias Public Health Centers of Excellence dedicated to promoting effective Alzheimer’s disease and caregiving interventions, as well as educating the public on Alzheimer’s disease, cognitive decline, and brain health. 

2.  Public Health Cooperative Agreements with the CDC that are awarded to State Health Departments to help them meet local needs in promoting brain health, reducing risk of cognitive decline, improving care for those with Alzheimer’s, and other key public health activities. 

3.  Data Grants to improve the analysis and timely reporting of data on Alzheimer’s, cognitive decline, caregiving, and health disparities at the state and national levels.

Since the original Bold Infrastructure for Alzheimer’s Act passed, the CDC has made 66 awards to 45 state, local and tribal public health departments to help them implement effective dementia interventions such as reducing risk, increasing early detection and diagnosis, and supporting the needs of caregivers.

“Alzheimer’s disease is one of the greatest and most under-recognized public health threats of our time. Nearly seven million Americans—including 29,600 Mainers—are living with the disease, and that number is soaring as our overall population grows older and lives longer,” said Maine Sen. Collins, a founder and Senate co-chair of the Congressional Task Force on Alzheimer’s Disease in a statement announcing the passage of the legislation.  

“The passage of this bipartisan legislation is a tremendous victory for families and communities nationwide. By reauthorizing the BOLD Infrastructure for Alzheimer’s Act, we are reaffirming our commitments to providing the tools needed to fight this devastating disease, and to not let Alzheimer’s be one of the defining diseases of our children’s generation as it has ours,” says Collins.

“Since the original BOLD Infrastructure for Alzheimer’s Act passed, public health departments have been able to improve brain health across the life course in their communities,” said Robert Egge, Alzheimer’s Association chief public policy officer and AIM president. “The BOLD Reauthorization Act will help public health departments implement effective strategies that promote brain health, address dementia, and support individuals living with dementia and their caregivers,” said Egge. “We urge the President to support the Alzheimer’s community and swiftly sign this bipartisan bill into law,” he says.

Rhode Island response

“Getting this bill across the finish line is a win for the 25,000 Rhode Islanders living with Alzheimer’s, their adult children who work tirelessly as unpaid family caregivers, and for the health and economic needs of the next generation too.  We must continue the progress we’ve made against Alzheimer’s.  We’ve got to find better treatments for Alzheimer’s and related dementias. The federal government must do its part to reduce risk, detect early symptoms, and advance care while lifting the burden on unpaid caregivers,” said RI Sen. Reed.

Since the original BOLD Infrastructure for Alzheimer’s Act passed in 2018, Reed noted that the Rhode Island Department of Health (RIDOH) has been awarded $3.8 million in BOLD Infrastructure for Alzheimer’s Act grants from the CDC. RIDOH has used the federal BOLD grant funds to help to implement effective Alzheimer’s interventions, including boosting early detection and diagnosis, reducing risk, and preventing avoidable hospitalizations, he says.

Victoria O’Connor, program manager at the RIDOH’s Alzheimer’s Disease and Related Disorders (ADRD), who chairs the state’s Advisory Council on ADRD, agrees with Sen. Reed’s assessment about the positive impact of this federal grant on state-wide public health interventions for those caring for persons with dementia.

“The RIDOH Alzheimer’s Disease and Related Disorders Program leads a statewide Advisory Council, convening critical partners, subject matter experts, and people with lived experience to advise implementation of the BOLD funded workplan as well as oversee the Rhode Island State Plan on Alzheimer’s Disease and Related Disorders 2024-2029. This collaborative approach has led to successful implementation of public health interventions statewide that aim to empower all individuals impacted by dementia to achieve their best quality of life.” says O’Connor.

Other congressional actions to combat Alzheimer’s  

Earlier this year, Sen. Reed helped pass the National Alzheimer’s Project Act (NAPA) Reauthorization Act and the Alzheimer’s Accountability and Investment Act (AAIA).  Sen. Whitehouse was also a cosponsor of the National Alzheimer’s Project Act (NAPA) Reauthorization Act.  Both bills were signed into law by President Biden. 

The NAPA Reauthorization Act (P.L.,118-93) reauthorizes NAPA through 2035, considered a roadmap to coordinate federal efforts in responding to Alzheimer’s and other forms of dementia.  Since NAPA was first passed in 2011, Alzheimer’s research funding has increased seven-fold.  Today, funding for research into Alzheimer’s and other dementias totals over $3.8 billion.

The Alzheimer’s Accountability and Investment Act (P.L. 118-93) would require the Director of the National Institutes of Health (NIH) to submit an annual budget to Congress estimating the funding necessary to fully implement NAPA’s research goals.  This will help ensure Congress can make a well-informed decision to determine necessary Alzheimer’s research funding levels.

We have made tremendous progress in recent years to boost funding for Alzheimer’s research, which holds great promise to end this disease that has had a devastating effect on millions of Americans and their families,” said Sen. Collins, who authored NAPA and AAIA.

“These two bills will maintain our momentum and make sure that we do not take our foot off the pedal just as our investments in basic research are beginning to translate into potential new treatments. We must not let Alzheimer’s to be one of the defining diseases of our children’s generation as it has ours,” she says.

And as a member of the Appropriations subcommittee that oversees funding for the National Institutes of Health (NIH), Sen. Reed helped provide a $275 million increase for Alzheimer’s disease research in the fiscal year 2025 Senate Labor, Health and Human Services, Education, and related Agencies Appropriations bill.  In 2019, NIH awarded Brown University researchers, along with Boston-based Hebrew SeniorLife (HSL), over $53 million in federal research funds  to lead a nationwide effort to improve health care and quality of life for people living with Alzheimer’s disease and related dementias, as well as their caregivers.

Putting the brakes on CMS proposed minimum staffing for nursing facilities

Published in RINewsToday on October 23, 2023

In response to the Centers for Medicare and Medicaid Services (CMS) recent release of proposed rule to establish minimum federal staffing requirements, last week 97 members of Congress, mostly Republican, called on Health and Human Services (HHS) Secretary Xavier Becerrato put the breaks on CMS’s proposed rule issued on Sept. 1, 2023.

In September, CMS issued a proposed rule establishing minimum staffing requirements and standards for nursing facilities. But the proposed CMS rule notes that according to the Bureau of Labor Statistics, “there are roughly 235,900 fewer health care staff working in nursing facilities and other long-term care facilities compared to March of 2020.”  Furthermore, the proposed CMS rule notes that nursing facilities around the country would need to hire nearly 13,000 registered nurses and 76,000 nursing assistants. Safety thresholds could increase a modest 1% while costing between $1.5 to $6.8 billion to fully implement. Noncompliance with CMS’ proposed minimum staffing requirements would lead to citations for noncompliance with Medicare Conditions of Participation, potentially resulting in a variety of enforcement actions, including imposition of Civil Monetary Penalties, denial of payments for new admissions, and even termination from the Medicare program.

Congressional call to CMS to reconsider minimum staffing rule

Congressman Greg Pence (R-IN), along House colleagues Brett Guthrie (R-KY), Vern Buchanan (R-FL), Michelle Fischbach (R-MN), Jared Golden (D-ME), and Chris Pappas (D-NH), along with 91 of their Republican colleagues sent a bipartisan letter to Department of Health and Human Services (HHS) Secretary Xavier Becerra, opposing minimum federal staffing requirements.

In this Oct. 20 letter, they charge that CMS’s rule would inevitably result in limited access to care for seniors, mandatory increases in state Medicaid budgets, and most consequentially lead to widespread nursing facility closures. they urge the Secretary to reconsider the proposal to impose new federal staffing requirements on nursing facilities which would adversely hurt their ability to serve existing and prospective residents.

In the letter, the lawmakers expressed their concerns with CMS proposed rule issued at the direction of the Biden White House. This rule would establish minimum staffing requirements and standards for nursing facilities, which they warned would inevitably result in limited access to care for seniors, mandatory increases in state Medicaid budgets, and most consequentially lead to widespread nursing home closures.

“At a time when nursing homes are already experiencing healthcare worker shortages and financial hardships, CMS and the Biden Administration should not be implementing a regulation that would only exacerbate this issue. If implemented, facilities throughout the country will have no choice but to deny access to our nation’s seniors who need nursing home care, especially in rural communities, like many of the ones I represent in Indiana’s sixth congressional district,” said Congressman Pence. “This one-size-fits-all regulatory requirement will result in many negative consequences, and I strongly urge Secretary Becerra to reconsider this proposal,” he said.

“There are workforce shortages all across rural America and healthcare workers are no exception. I’m committed to working with my colleagues to find ways to prevent otherwise avoidable closures of nursing homes in Maine,” said Congressman Golden.

Nonprofit provider group calls on Congress to stop CMS proposed rule

The Washington, DC-based LeadingAge, representing more than 5,000 nonprofit aging services providers, gave the thumb up to House lawmakers who are attempting to delay CMS’s proposed rule until there are enough qualified applicants and adequate funding to address staffing levels realistically throughout the long-term care continuum.

“We all want to ensure access to quality care for older adults, but federal leaders are getting it wrong right now,” said Katie Smith Sloan, president and CEO, Leading Age, the association of nonprofit providers of aging services, including nursing homes. “CMS’s proposed nursing home staffing mandate rule works against that shared goal, and would limit older adults’ and families’ access to care,” she said.

In a letter sent to Congressional leaders on Sept. 28, 2023 addressing the Centers for Medicare and Medicaid Services (CMS) September 1 proposed rule on nursing home staffing mandates, Sloan urged policymakers to focus on advancing real solutions to ensure quality nursing home care for older adults and families across America. 

Sloan’s letter lays out three main reasons why the proposed rule will be impossible to implement.  She notes that no federal funding has been allocated to cover the $7.1 billion price tag of CMS’s proposed regulation.  She warns that the mandate would require the hiring of 90,000 more workers, and there are simply not enough people to hire.  Finally, the mandating staffing requirements could decrease access to care across the continuum of care, says the top aging services executive.

The letter asks Congress to intervene to delay the proposed rule until there are enough qualified applicants and adequate funding to address staffing levels. Sloan provides her association’s independent cost analysis of the proposed rule, which projects implementation would be at least $7.1 billion—far higher implementation than CMS estimates.

“The costs of delivering quality care already far exceed Medicaid reimbursement levels, and this unfunded mandate will force nursing homes to consider limiting admissions or even closing their doors for good, depriving older adults and their families of care in their communities,” states the letter, noting that “the outcome is the opposite of what providers, lawmakers, the administration and the American people want.”

According to Sloan, nursing facilities aren’t the only part of the healthcare system that will be affected if the rule is implemented as proposed. Home health providers are already rejecting referrals and some face closure due to financial pressures and workforce shortages. There will be far fewer options for older adults and families to access care, and communities of color and less affluent individuals will feel the deepest impact, she says. 

“The current and highly fragmented approach to long-term care financing no longer serves the millions of older adults who require compassionate and highly skilled care,” writes Sloan, calling on Congress to work with the Administration on realistic solutions, including a “robust national workforce development strategy.” 

LeadingAge has put forward solutions to tackle the aging services workforce crisis including prioritizing immigration reform to help build the pipeline of workers; increasing funding and working with states to increase Medicaid reimbursement rates to cover the cost of care and increase wages; along with replicating existing successful training programs and expand opportunities for interested applicants to pursue careers as RNs, LPNs, and CNAs. 

“We need a holistic approach to real solutions to the workforce crisis. Let’s get this right,” said Sloan.

A Rhode Island perspective

“Unfortunately, a staffing ratio mandate, whether state or federal, is a blunt enforcement instrument that does not consider the numerous challenges facing providers, including Medicaid underfunding, lack of workforce, and the diversity of nursing homes and their resident needs,” says James Nyberg, president, and CEO of LeadingAge Rhode Island. “Moreover, the concept of imposing severe financial penalties for homes that are unable to meet a staffing ratio is counterproductive at best by siphoning off scarce resources that providers need as they seek to address their workforce needs and resident care needs,” he says. 

“We in Rhode Island can attest that there are numerous unintended consequences of a staffing ratio mandate, including the severity of fines, how compliance is measured and calculated, costs of compliance (or trying), backlogs of people in hospitals waiting for skilled nursing care, and other access-related issues, says Nyberg, noting that even homes that are currently able to comply with the staffing ratio are doing so at an unsustainable cost. 

According to Nyberg, a staffing ratio mandate without an adequate workforce supply, as well as financial resources, poses an existential threat to the industry. LeadingAge Rhode Island is working with state officials and other stakeholders to revisit some of the more onerous provisions of our mandate, mitigate its effects, and pursue other less punitive approaches to meeting collective goal of ensuring adequate staffing and quality of care while also working on various initiatives to develop a pipeline of workers, which will quite simply take time. 

For a copy of the Oct. 20 correspondence sent to HHS Secretary Xavier Becerra urging her to reconsider establishing minimum staffing in nursing facilities, go to https://drive.google.com/file/d/1RzhXgF2OQR-cbz8fA5I4yE0DWYn8fDJM/view.

To read LeadingAge’s Sept. 28 correspondence to Congress, go to https://leadingage.org/wp-content/uploads/2023/09/LeadingAge-Staffing-Mandate-Analysis-Congressional-Letter-9-28-2023.pdf.

For a copy of a CMS Fact Sheet on CMS’s proposed rules on minimum staffing, go to https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid