Workforce shortages are beginning to impact patient care. Media reports indicate numerous instances of hospitals declaring “contingency standards of care,” or ordering ambulance diversions, due to staffing shortages. CMS needs to act before such practices become commonplace in dialysis facilities. Medicare’s proposed dialysis payment for 2024 would only increase reimbursements by 1.7%, despite labor costs that have risen by 9.7% over the past two years. Complicating matters further, calculation errors the past two annual cycles have left payments 4 percentage points below what they should be. DPC has asked Medicare to apply an Essential Worker Safety Catch, to look back on previous updates, and reconsider current forecasts, so updates are accurate and don’t fall behind actual changes in market wages.