New Trump Guidance Could 'Result in the Disenfranchisement of Nursing Home Residents'

The Trump administration's far-reaching assault on voting rights has extended to nursing homes, a group of Democratic senators warned on Thursday, pointing to federal guidance recently issued by the Center for Medicare and Medicaid Services.

The guidance, released in July, removes previous recommendations on how nursing home staff can assist residents in exercising their constitutional rights and warns facility employees against violating "federal or state voting laws." The guidance points to a highly dubious Texas case in which a social worker was charged with orchestrating an election fraud scheme, even though no improper votes were cast.

In a letter sent earlier this week to CMS Administrator Mehmet Oz, Sens. Alex Padilla (D-Calif.), Elizabeth Warren (D-Mass.), and 11 other Democrats argued that the agency's July guidance "may intimidate nursing home staff from helping residents exercise their constitutional right to vote and ultimately prevent nursing home residents from voting."

"The nation’s 1.2 million nursing home residents face unique problems in obtaining access to the voting booth," the lawmakers added, "and must not be denied their rights because they are disabled, elderly, lack transit, or face difficulties in obtaining a ballot or voting in person."

The senators emphasized that the new CMS memo breaks with guidance issued during President Donald Trump's first term in the White House. That guidance, issued in October 2020, states that "nursing homes should have a plan to ensure residents can exercise their right to vote, whether in person, by mail, absentee, or other authorized process."

Such language is entirely absent from the new guidance, which focuses heavily on preventing voter fraud—an obsession of Trump's, despite it being extremely rare in the US.

"CMS's release of this memo is just the latest in a series of actions the Trump administration has taken to restrict vote by mail and undermine the right to vote based on unfounded allegations of voter fraud tied to the president’s denial of prior valid election results," the Democratic senators wrote in their letter. "We are concerned that by highlighting examples of prior voter fraud investigations and threatening criminal penalties on nursing home staff—many of whom are legal immigrants who have already been targeted by Trump’s immigration policies—CMS’s July 2026 guidance may intimidate nursing home staff from helping residents with the voting process."

"And the removal of guidance on vote by mail procedures, combined with specific threats to investigate nursing home staff for assisting residents who are exercising their right to vote, may deter nursing homes from assisting residents with voting by mail," they added. "Ultimately, we are concerned that the changes to CMS’s guidance will result in the disenfranchisement of nursing home residents."

The Houston Chronicle, in its coverage of the new CMS guidance, spotlights the Trump administration's decision to cite the Texas case, which involved social worker Kelly Brunner.

"When Kelly Brunner was tasked in 2020 with getting the State Supported Living Center in Mexia ready to vote, she was excited to assist the residents with intellectual and developmental disorders prepare for a big election. Instead, her work as the assistant voter registrar at the facility east of Waco spiraled into a nightmare," the outlet noted. "Brunner admitted making technical errors in the complicated registration system, which were all quickly caught; no resident cast an improper vote. Yet, pushed by Attorney General Ken Paxton—who at the time was promoting President Donald Trump’s false claims of a rigged presidential election—she was criminally charged with orchestrating one of the largest election fraud cases ever in Texas."

"Brunner spent $50,000 on lawyers, pleaded guilty to minor charges to put it behind her, lost her teacher’s license and nearly her social worker’s license," the Chronicle added. "Still, she thought the episode was finally over—until... [CMS] cited Brunner as the reason it needed to officially place employees of long-term care facilities on notice that they should be on the lookout for voter fraud in the upcoming midterm elections."

Richard Mollot, executive director of the New York-based Long Term Care Community Coalition, told the Chronicle that the Trump administration's heavy focus on preventing voter fraud "will have a chilling effect" on nursing home resident voting.

"The language is important,” said Mollot. “Most nursing homes will do as little as possible; if you’re not affirmatively telling them what to do, they won’t do it."