Staffing ‘instability’ might be new mandate metric; providers gear up for battle

Average day-to-day staffing levels may be a key way to measure impact on nursing home care quality, a new study finds as federal regulators move closer to their goal of a proposed staffing mandate.

Nursing homes that keep day-to-day nursing staff stable, especially by avoiding days with low LPN or CNA presence, perform better on a variety of patient outcomes, researchers from the University of California and the University of Chicago reported in JAMA Network Open Tuesday.

A first-ever federal mandate, widely feared by providers who find themselves underpaid and hampered by daunting recruitment challenges, is expected to be issued by early this spring. 

The researchers behind Tuesday’s JAMA Network Open study say their findings should be used to help shape CMS’ draft proposal.

“The information provided here, about both the HPRD and below-average staffing days, is relevant and may inform these efforts,” wrote the team, which included Dana B. Mukamel, PhD, of the Department of Medicine at the University of California-Irvine and R. Tamara Konetzka, PhD, of the Department of Public Health Sciences at the University of Chicago.