The Centers for Medicare & Medicaid Services (CMS) invites interested members of the public to a call on August 29, 2022, from 1:00 to 2:30 EST, to discuss nursing home staffing; Register here.
The CMS blog announcing the call also describes the nursing home staffing study that President Biden announced as part of his nursing home reform agenda in February. CMS is taking a “multi-faceted approach aimed at determining the minimum level and type of staffing needed to enable safe and quality care in nursing homes.” CMS plans to issue a notice of proposed rulemaking in the Spring 2023 and promises that “Facilities will be held accountable if they fail to meet this standard.”
CMS first describes what it learned from the Request for Information that it included in the April 2022 notice of proposed rulemaking for the annual update to Medicare Part A reimbursement. Briefly, CMS notes that resident advocacy groups and family members “were generally strongly supportive of establishing a minimum staffing requirement, while other industry and provider groups expressed significant concern.”
CMS next describes the staffing study now underway, which buildings on previous studies and includes:
- Literature review
- Site visits to 75 nursing homes in 15 states (CA, CO, FL, IL, MA, MD, MO, NC, NY, OH,PA TX, VA, WA, and WY). These site visits, involving interviews (with nursing staff, residents, families), surveys, and direct observations of direct care staff, “will provide qualitative, contextual information to inform the establishment of minimum staffing requirements.” Data collected at the site visits “will enable the development of a simulation model to examine the impact of different staffing levels and patient acuity levels on the quality and timeliness of care.” CMS describes the simulation model as “important to ensure that the staffing study reflects not just what staffing levels exist currently as a descriptive model, but also what staffing levels are needed for safe, quality care for patients at varying acuity levels [italics in original].”
CMS also intends to identify the impact of staffing levels on quality, barriers to implementation of staffing levels, “and any potential unintended consequences of imposing minimum staffing requirements.”
- Quantitative analyses will “identify staffing levels associated with improved quality of care and resident safety in nursing homes.” CMS will also examine trends in staffing from 2018-2021 and identify “specific factors that are related to staffing levels.”
- Cost analyses, needed for all rulemaking, will identify costs of meeting the new staffing requirements.
CMS’s blog post, “Centers for Medicare & Medicaid Services Staffing Study to Inform Minimum Staffing Requirements for Nursing Homes,” is at https://www.cms.gov/blog/centers-medicare-medicaid-services-staffing-study-inform-minimum-staffing-requirements-nursing-homes
August 25, 2022 – T. Edelman