To Advance Information on Quality of Care, CMS Makes Nursing Home Staffing Data Available
Turnover added to Staffing Five Star and Care Compare
CMS announced they will begin posting turnover and weekend staffing data for each nursing home on the Medicare.gov Care Compare website.
Weekend Staffing measures the level of total nurse and registered nurse (RN) staffing on weekends provided by each nursing home over a quarter. Staff Turnover measures the percent of nursing staff and number of administrators that stopped working at the nursing home over a 12-month period.
This information will be added to the Care Compare website in January 2022 and used in the Nursing Home Five Star Quality Rating System in July 2022.
To Advance Information on Quality of Care, CMS Makes Nursing Home Staffing Data Available
As part of its commitment to improve transparency and help families and caregivers find the best quality of nursing home care for their loved ones, the Centers for Medicare & Medicaid Services (CMS) will begin posting for the first time ever, staff turnover rates and weekend staff levels for nursing homes on the Medicare.gov Care Compare website today. Staffing in nursing homes has a substantial impact on the quality of care and outcomes residents experience. Having access to this information helps consumers understand more about each nursing home facility’s staffing environment and choose a facility that provides the highest quality of care that best meets the healthcare needs of their loved one.
Staff turnover is the percent of nursing staff and number of administrators that stopped working at a nursing home over a 12-month period.
Centers for Medicare & Medicaid Services. “To Advance Information on Quality of Care, CMS Makes Nursing Home Staffing Data Available | CMS.” CMS News and Media Group, 26 Jan. 2022, www.cms.gov/newsroom/press-releases/advance-information-quality-care-cms-makes-nursing-home-staffing-data-available
CMS going public with facility turnover, weekend staffing data
The Centers for Medicare & Medicaid Services late Friday announced that it will begin posting nursing home staff turnover rates and weekend staffing levels on the consumer-facing Medicare Care Compare site this month.
The same information will then be incorporated into the public Five-Staring rating system in July. The moves intensify pressure on providers that are facing a historic workforce shortage with no clear end in sight.
“Staffing in nursing homes has a substantial impact on the quality of care and outcomes residents experience,” CMS said in a memo announcing its decision to add the turnover rates and weekend levels to staffing averages that have been included for a decade.
The additional information “further enhances the information available to consumers, residents, and families to help support their healthcare decisions and incentivizes quality improvement among nursing homes,” the agency said.
Marselas, Kimberly. “CMS Going Public with Facility Turnover, Weekend Staffing Data.” McKnight’s Long-Term Care News, 10 Jan. 2022, www.mcknights.com/news/cms-going-public-with-facility-turnover-weekend-staffing-data.
Are you ready for staff turnover reporting?
- Weekend staffing — the level of total nurse and registered nurse (RN) staffing on weekends over a quarter
- Staff turnover — the percent of nursing staff and number of administrators that stopped working at the nursing home over a 12-month period
- Detailed staffing data — employee-level staffing data
These additions are not unexpected after several high-profile reports published last year. However, news that CMS would immediately begin posting this data to the Care Compare website in January 2022 — and incorporate the measures into the Five-Star Staffing rating in July 2022 — caught many by surprise.
Timeline of events…
Feige, Jenn. “Tips for the PBJ Pro: Are You Ready for Staff Turnover Reporting?” SimpleLTC, 11 Jan. 2022, www.simpleltc.com/tips-for-the-pbj-pro-are-you-ready-for-staff-turnover-reporting.
Technical Users’ Guide for the Care Compare Nursing Home Updates
On January 14, 2022, Centers for Medicare & Medicaid Services updated the Technical Users’ Guide for the Care Compare Nursing Home Five-Star Quality Rating System. While this information will be publicly reported starting in January, it will not be used in the Five-Star Quality Rating System until July 2022.
Here is what you need to know about the changes. Starting with the January 2022 refresh on the Care Compare Website, CMS will begin to report the following:
Doran, Mattie. “Technical Users’ Guide for the Care Compare Nursing Home Updates.” Blue & Co., LLC, 25 Jan. 2022, www.blueandco.com/technical-users-guide-for-the-care-compare-nursing-home-updates.
‘Tone deaf’: Posting of more staffing and turnover data starts
Nursing home staff turnover rates and weekend staffing levels can now be viewed publicly on the Care Compare website, the Centers for Medicare & Medicaid Services announced Wednesday.
The decision, though well-intentioned, could not have come at a worst time for many nursing homes who are already struggling with severe staffing shortages exacerbated by the pandemic, many provider advocates say.
“While we support transparency and agree that staffing hours and turnover metrics are important, more reporting will not solve this issue,” the American Health Care Association said in a statement Wednesday. “The addition of these metrics on Care Compare when we are in the middle of the worst labor shortage the nursing home sector has ever faced is tone deaf.”
Brown, Danielle. “‘Tone Deaf’: Posting of More Staffing and Turnover Data Starts.” McKnight’s Long-Term Care News, 27 Jan. 2022, www.mcknights.com/news/tone-deaf-posting-of-more-staffing-and-turnover-data-starts.
CMS Makes Nursing Home Staffing Data Available
Last week, the Centers for Medicare & Medicaid Services (CMS) began posting, for the first time ever, staff turnover rates and weekend staff levels for nursing homes on the Medicare.gov Care Compare website.
CMS calculates staff turnover as the percent of nursing staff and number of administrators that stopped working at a nursing home over a 12-month period. The nursing staff included in this measure includes licensed nurse staff—i.e., registered nurses (RNs); licensed practical and vocational nurses; as well as nurse aides who work under the direction of licensed nurse staff and provide much of the day-to-day care for nursing home residents such as eating, bathing, grooming, and toileting. Weekend staffing is the level of total nurse and RN staffing on weekends provided by each nursing home over a quarter.
CMS has explored the relationship between staff turnover and quality of care and a preliminary analysis indicates that as the average staff turnover decreases, the overall star ratings for facilities increases, suggesting that lower turnover is associated with higher overall quality.
“CMS Makes Nursing Home Staffing Data Available | AMDA | The Society for Post-Acute and Long-Term Care Medicine.” The Society for Post-Acute and Long-Term Care Medicine, 28 Jan. 2022, paltc.org/?q=publications/cms-makes-nursing-home-staffing-data-available.
New Staffing Measures Posted to Care Compare
- The percentage of RN staff that left the facility over the last year.
- The percentage of total nursing staff that have left the facility over the last year.
- The number of administrators that have left the facility over the last year.
- Weekend Total Nurse (RN, LPN, & Aide) hours per resident day (HPRD).
- Weekend RN HPRD.
AHCA/NCAL Staf. “New Staffing Measures Posted to Care Compare.” Provider Magazine, 2 Feb. 2022, https://www.providermagazine.com/Articles/Pages/New-Staffing-Measures-Posted-to-Care-Compare.aspx
Consumers Are Getting New Information About Nursing Home Staffing But Need More
With nursing homes and other long-term care facilities desperately short of nurses and aides, it is more important than ever for consumers to know about staffing levels, quality, and turnover. But it has been difficult to get some key information. Now, the government has taken a modest step to help.
In January, the Centers for Medicare and Medicaid Services (CMS) began posting new information about weekend nursing home staffing of Registered Nurses (RNs) as well as a total staffing including Licensed Practical Nurses (LPNs), Licensed Vocational Nurses (LVNs), Certified Nurse Aides (CNAs), and nurse aides in training. CMS also has begun reporting data on turnover rates of nurses and administrators.
This information is valuable for consumers, but it is not enough.
Gleckman, Howard. “Consumers Are Getting New Information About Nursing Home Staffing But Need More.” Forbes, 9 Feb. 2022, www.forbes.com/sites/howardgleckman/2022/02/03/consumers-are-getting-new-information-about-nursing-home-staffing-but-need-more
PBJ Update: Changes to the Staffing Measures & Impact on Five-Star Staffing Rating
- Discuss the two weekend staffing measures and their calculation methodology
- Review new exclusion rules for staffing data that will result in an automatic one star
- Discuss the staff turnover measure and its calculation methodology
- Review exclusion criteria for turnover measure
- Provide insight to help manage the PBJ submission process and improve Staffing Star results
Jones, Joanne. “PBJ Update: Changes to the Staffing Measures and Impact on Five-Star Staffing Rating.” FORVIS, 9 Feb. 2022, www.forvis.com/webinar/2022/02/pbj-update-changes-staffing-measures-impact-five-star-staffing-rating.
Related CMS and PBJ Resources
To learn more about the details, policies and information in these articles, please review these CMS and PBJ publications.