Additional Reporting on Key Staffing Information and Stronger Payment Incentives Needed for Skilled Nursing Facilities

Published: March 9, 2021, Revised August 10, 2021

CMS has taken important steps to build a new source for data on nursing home staffing and to use these data to better inform consumers and improve nursing home oversight. CMS provides the public with some of this staffing information on the Care Compare website. There, consumers can use Staffing Star Ratings to compare nurse staffing between nursing homes. Additionally, CMS has implemented a robust process to ensure the reliability of this nurse staffing information.

However, CMS has opportunities to better use the staffing information that nursing homes report. Specifically, the staffing information that CMS provides on Care Compare could be more useful to consumers if it included data on nurse staff turnover and tenure, as required by Federal law. CMS reported that the COVID-19 pandemic delayed its progress to implement these requirements.

Recommendations provided include:

  • CMS should report weekend decreases in RN and total nurse staffing levels on Care Compare
  • CMS should report minimum RN and total nurse staffing thresholds below which SNF residents are at increased risk of quality problems on Care Compare
  • CMS should assess the feasibility of incorporating into the Five-Star System staffing ratings information on weekend decreases in RN and total nurse staffing levels

Government Accountability Office. “Additional Reporting on Key Staffing Information and Stronger Payment Incentives Needed for Skilled Nursing Facilities” GAO-21-408 August 9, 2021.