Skilled nursing facilities should anticipate federal minimum staffing standards, with CMS expected to advance rulemaking in 2023.
Nursing Facility Staffing — MedPAC
Between the first quarter of 2019 and the fourth quarter of 2021, there was a six-minute decline in hours per resident day for CNAs, while RNs and LPNs saw a minimal increase in 2020 before returning to near pre-pandemic levels in 2021. The percentage of contract staff contributing to total hours per resident day nearly tripled from 3% in Q1 2019 to 8.4% in Q4 2021.
Linehan, Kathryn, and Lauren Stubbs. Nursing Facility Staffing. MedPAC, 29 Sept. 2022, https://www.medpac.gov/wp-content/uploads/2021/10/Nursing-Facility-Staffing-MedPAC-29-Sept-2022.pdf.
State staffing policies could hamper MedPAC’s recommendations on federal mandate
A federal minimum staffing mandate is on the horizon for nursing homes at the beginning of 2023. Providers and experts wonder just how the proposed mandate might address historic staffing shortages without resources or support.
Although a minimum staffing ratio for nursing homes sounds like a good policy, money is needed to turn the idea into reality, the Medicare Payment Advisory Commission (MedPAC) said at its Sept. 30 meeting.
State staffing policies for nursing homes would also come into play, which could complicate their ability to make quality recommendations to the Centers for Medicare & Medicaid Services and Congress.
MedPAC could help CMS develop its standard using payroll-based journal data. MedPAC, however, is not in a position to release any specific recommended staffing minimum.
— McKnight’s Senior Living, October 11, 2022
‘Powerful Data’ Could Inform CMS’ Nursing Home Minimum Staffing Standards
As federal minimum staffing requirements loom for skilled nursing providers, analysts with the Medicare Payment Advisory Commission (MedPAC) unveiled crucial data detailing the effects of state-level standards on the industry.
While research found state minimum staffing requirements increased staffing levels and in some cases improved quality measures, there were some unintended consequences: a decrease in indirect staffing and skill mix, or the number of registered nurses (RNs) and licensed practical nurses (LPNs) relative to certified nursing assistants (CNAs).
Multiple board members commented on the “powerful” data, yet others were unsure if MedPAC would be “positioned or capable” of drawing up their own suggestion for a minimum staffing requirement.
Instead, members hope the data will better inform CMS’ development of new standards where they are warranted.
— Skilled Nursing News, September 29, 2022
