This month, the Centers for Medicare & Medicaid Services (CMS) will begin posting nursing staff turnover information and weekend staffing levels on the federal website Care Compare.[1] Specifically, CMS will post:
Staff Turnover: “The percent of nursing staff and number of administrators that stopped working at the nursing home over a 12-month period.” CMS will post:
- “The percent of [registered nurse] RN staff that left the facility over the last year.
- “The percent of total nurse staff that have left the facility over the last year.
- “The number of administrators that have left the facility over the last year.”
Weekend Staffing: “The level of total nurse and registered nurse RN staffing on weekends provided by each nursing home over a quarter.”
CMS will post the level of weekend RN and total nurse staff (RN, licensed practical nurse (LPN), certified nurse aide (CNA), “reported in terms of the average number of RN and total nurse hours worked per resident per day on weekends.”
Beginning in July 2022, CMS will use the staff turnover and weekend staffing information in its Nursing Home Five Star Quality Rating System.
CMS cites reports by the HHS Inspector General about staffing and Care Compare. One report found that lower staffing levels on weekends are not reported on the federal website;[2] the other called for posting of information on staff turnover and tenure,[3] as explicitly required by the Affordable Care Act.[4]
In its memorandum, CMS identifies a number of factors that may suggest why lower turnover rates are associated with higher quality of care for residents. For example, staff may be more familiar with residents and more able to identify changes in residents more quickly; staff may be more familiar with facility policies and procedures; and lower administrator turnover may reflect “greater leadership stability, direction, and operations, which may help staff provide care more consistently or effectively to residents.”
January 13, 2022 – T. Edelman
[1] CMS, “Nursing Home Staff Turnover and Weekend Staffing Levels,” QSO-22-08-NH (Jan. 7, 2022), https://www.cms.gov/files/document/qso-22-08-nh.pdf
[2] HHS Office of Inspector General, “Some Nursing Homes’ Reported Staffing Levels in 2018 Raise Concerns; Consumer Transparency Could Be Increased” (Data Brief), OEI-04-18-00450 (Aug. 20, 2020), https://oig.hhs.gov/oei/reports/OEI-04-18-00450.pdf
[3] HHS Office of Inspector General, “CMS Use of Data on Nursing Home Staffing: Progress and Opportunities To Do More,” OEI-04-18-00451 (Mar. 2021), https://oig.hhs.gov/oei/reports/OEI-04-18-00451.pdf
[4] 42 U.S.C. §§1395i-3(i)(1)(A)(i), 1396r(i)(1)(A)(i), Medicare and Medicaid, respectively