This
month, the Centers for Medicare & Medicaid Services (CMS) will begin
posting nursing staff turnover information and weekend staffing levels on the
federal website Care Compare.[1] Specifically,
CMS will post:
Staff Turnover: “The percent of nursing staff and
number of administrators that stopped working at the nursing home over a
12-month period.” CMS will post:
- “The percent of [registered nurse] 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.”
Weekend Staffing: “The level of total nurse and
registered nurse RN staffing on weekends provided by each nursing home over a
quarter.”
CMS
will post the level of weekend RN and total nurse staff (RN, licensed practical
nurse (LPN), certified nurse aide (CNA), “reported in terms of the average
number of RN and total nurse hours worked per resident per day on weekends.”
Beginning
in July 2022, CMS will use the staff turnover and weekend staffing information
in its Nursing Home Five Star
Quality Rating System.
CMS
cites reports by the HHS Inspector General about staffing and Care Compare. One
report found that lower staffing levels on weekends are not reported on the
federal website;[2] the
other called for posting of information on staff turnover and tenure,[3] as explicitly required
by the Affordable Care Act.[4]
In
its memorandum, CMS identifies a number of factors that may suggest why lower
turnover rates are assoiated with higher quality of care for residents. For
example, staff may be more familiar with residents and more able to identify
changes in residents more quickly; staff may be more familiar with facility
policies and procedures; and lower administrator turnover may reflect “greater
leadership stability, direction, and operations, which may help staff provide
care more consistently or effectively to residents.”
___________________
[1] CMS, “Nursing Home
Staff Turnover and Weekend Staffing Levels,” QSO-22-08-NH (Jan. 7, 2022), https://www.cms.gov/files/document/qso-22-08-nh.pdf
[2] HHS Office of
Inspector General, “Some Nursing Homes’ Reported Staffing Levels in 2018 Raise
Concerns; Consumer Transparency Could Be Increased” (Data Brief),
OEI-04-18-00450 (Aug. 20, 2020), https://oig.hhs.gov/oei/reports/OEI-04-18-00450.pdf
[3] HHS Office of
Inspector General, “CMS Use of Data on Nursing Home Staffing: Progress and
Opportunities To Do More,” OEI-04-18-00451 (Mar. 2021), https://oig.hhs.gov/oei/reports/OEI-04-18-00451.pdf
[4] 42 U.S.C.
§§1395i-3(i)(1)(A)(i), 1396r(i)(1)(A)(i), Medicare and Medicaid, respectively
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