Instability In Staffing Levels at Nursing Homes Affects Quality of Care for Residents

Nursing home staffing levels often decline on weekends. In November 2018, the Centers for Medicare & Medicaid Services (CMS) identified facilities with low staffing on weekends and directed states to conduct surveys in a portion of these facilities on weekends. Then, in January 2022, CMS began posting weekend nurse staffing levels at nursing homes, in addition to a single staffing measure, citing two reports by the Health and Human Services’ Office of Inspector General about the need for additional staffing information on the federal website Care Compare.

A new study confirms the importance of providing more detailed staffing information to the public. Analyzing staffing levels at 14,499 nursing facilities in 2017 and 2018, researchers found that daily variation in nurse staffing levels (registered nurses (RNs) and certified nurse assistants (CNAs)), which they describe as “instability of staffing levels,” negatively affects quality of care for residents. They note that although consumers recognize the importance of staffing hours in general, they may not understand that daily staffing variability is also associated with quality. They explain why: