Amidst a nationwide nursing and skilled nursing facility staffing crisis, the Centers for Medicare & Medicaid Services (“CMS”) announced that additional information regarding nursing home staff numbers will be added to the January 2022 CMS Care Compare website. The staffing data will impact the Five-Star Quality Rating calculations in the middle of 2022. Skilled nursing compliance actions are needed to prevent a possible loss of stars in the CMS Five-Star Quality Rating.
On January 7, 2022, the Quality, Safety & Oversight Group at CMS issued a memorandum entitled “Nursing Home Staff Turnover and Weekend Staffing Levels” that unpacks the plan CMS has to begin posting weekend staffing and staff turnover data on the CMS Care Compare website.
CMS has been posting information on facility staffing measures on the Medicare.gov website called Care Compare, including the average number of hours worked reported for nursing staff, per resident per day.
These staffing measures are also used to calculate each nursing home’s star rating for the staffing rating domain as part of the Nursing Home Five Star Quality Rating System.
The information that CMS will report is intended to further enhance the information available to consumers, residents and families to help support their health care decisions and incentivizes quality improvement among nursing homes.
Weekend Staff
CME has had concerns regarding low staffing on weekends. CMS is also concerned that consumers may not have a clear understanding of how staffing levels at nursing homes may change from day to day, particularly on weekends.
In August 2020, the OIG recommended that CMS explore ways to provide consumers with additional information on nursing homes’ daily staffing levels and variability, such as how nursing homes’ weekend staffing compares to that of other nursing homes with the same Staffing Star Rating.
Nursing homes currently submit the number of hours that direct care staff work each day, the data can also be used to analyze differences between the level of staffing provided on weekends as compared to weekdays.
CMS will begin posting data on the level of weekend registered nurse and total nurse (this includes RN, licensed practical nurse, certified nurse aide) staffing for all nursing homes on the Care Compare website in January 2022.
This data will be reported in terms of the average number of registered nurses and total nurse hours worked per resident per day on weekends.
In addition, CMS will also add the measure of total nurse staffing on weekends to the staffing rating domain of the Nursing Home Five Star Quality Rating System in July 2022.
Staff Turnover
Nursing homes are also required to include information on employee turnover and tenure. CMS has stated that the association between turnover and quality is important and is valuable to consumers.
CMS plans to post the following measures of staff turnover in January 2022 and include these measures in the staffing domain of the Nursing Home Five Star Quality Rating System in July 2022:
- The percent of RN staff that left the facility over the last year.
- The percent of total nurse staff that have left the facility over the last year.
- The number of administrators that have left the facility over the last year.
Next Actions
- Nursing homes must link employee identifiers to ensure their turnover measures are accurate. It is critical that facilities use the methodology to link old and new employee identifiers together when these identifiers change.
- Nursing homes must read and understand the various data items in the categories.
- Nursing homes need to monitor and have systems in place to validate the staffing data prior to submission.
If you have questions or would like additional information about this topic, please contact:
- Sean Fahey at (317) 977-1472 or sfahey@wp.hallrender.com; or
- Your regular Hall Render attorney.
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