Industry analyses project $6.5B annual cost and widespread compliance gaps

PBJ News | Minimum Staffing News Roundup
Our Take: Multiple analyses drawing from AHCA/NCAL, Altarum, and independent consultants project that CMS’s minimum staffing mandate will cost the industry at least $6.5 billion annually and require more than 102,000 additional clinicians. Only 1% of facilities currently meet all staffing thresholds and per state compliance ranges from 2% to 100%. ▼
The minimum staffing rule presents substantial operational and reporting challenges for skilled nursing operators nationwide.

New federal staffing mandate poses greater challenge in some states, Altarum reports

“There is wide variation among states in the percent of nursing homes that meet the new standards, ranging from 100% in Alaska to 2.4% in Louisiana. This variation is driven in part by differences among states in the impact of for-profit status, racial mix and percent of residents funded by Medicaid on whether a nursing home in a state meets the standards.”

— McKnight’s Senior Living, August 26, 2024

‘A Mountain to Climb’: As Nursing Homes Foresee Difficulties Meeting New Staffing Rule, Enlarging Workforce Pool Is a Leading Challenge

“Only 160, or 1%, out of a total of 14,500 facilities will meet the new requirements as of the summer quarter of 2023. This indicates that a substantial majority of nursing homes are not currently equipped to meet these new standards, highlighting the scale of the challenge ahead.”

— Skilled Nursing News, June 12, 2024

Staffing mandate costs estimated at $6.5B annually, with 1 in 4 residents at risk of displacement, AHCA warns

“A combination of those costs and the shortage of available long-term care workers also could place as many as 290,000 nursing home residents — nearly one-quarter of the total in the US — in danger of losing access to care, according to the analysis. Thursday’s report estimated that 94% of nursing homes will need to hire more staff to meet the mandate’s requirements — a total of more than 100,000 registered nurses and nurse aids.”

— McKnight’s Long-Term Care News, May 10, 2024

AHCA/NCAL: Nursing Home Staffing Rule Will Cost $6.5B Annually, Require 102,000 Extra Clinicians, Displace a Quarter of Residents

“AHCA/NCAL used staffing, cost and facility data from the federal government, including CMS’ Payroll Based Journal, Medicare Cost Reports and Care Compare. Additional key findings included the fact that only 6% of nursing homes currently meet all requirements in the rule.”

— Skilled Nursing News, May 9, 2024

Altarum: Funding, Staffing Level Fluctuations During Pandemic Should Be Part of Proposed Mandate

“[I]ncreasing staffing levels to meet the new requirements would require much faster overall spending growth. To the contrary, where such standards are not enacted with the resources required to meet them, the trends described in this paper suggest that extensive understaffing will likely continue.”

— Skilled Nursing News, November 17, 2023

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