Staffing takes a front seat when driving quality of care

Dec 12, 2019 | Five Star Staffing Ratings, Nursing HPRD & Turnover

Staffing takes a front seat when driving quality of care

…In CMS’s new rating methodology, facilities are rewarded for staffing more RNs — and punished when they don’t have enough. Ratings on the staffing domain are based on two measures: the number of RN hours per resident per day and total nursing hours (combined RN, LPN, and nurse aide hours) per resident per day, all pulled from quarterly Payroll-Based Journal reports.

Both the RN score and the total nurse score are rated, and the two scores are averaged together to determine the total score, giving the RN score a higher weight…

In this way, not only does CMS penalize facilities for going without a RN for three days, but it is demonstrating significant preference for RNs by leveraging RN staffing scores to directly influence the facility’s overall rating.




December 12, 2019


Caulfield, Chris. “Staffing Takes a Front Seat When Driving Quality of Care.” McKnight’s Long-Term Care News, 12 Dec. 2019,

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