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CMS Oversight of Nursing Home Staffing Levels

Nursing homes are intended to be places of comfort and healing. More than 1.4 million individuals live in over 15,500 Medicare- and Medicaid-certified nursing homes across the nation.

Everyone knows staffing is the most significant issue when determining whether your loved one gets the care he or she needs. Staffing levels have a direct impact resident care. Nursing facilities that receive Medicaid and Medicare payments must provide sufficient licensed nursing services 24 hours a day, including a registered nurse for at least 8 consecutive hours every day. Since 2016, CMS has used auditable daily staffing data, called the Payroll-Based Journal, to analyze staffing patterns and populate the staffing component of the Nursing Home Compare website – a site that enables the public to compare the results of health and safety inspections, the quality of care provided at nursing facilities, and staffing at nursing facilities.

In February 2022, President Biden announcedcomprehensive set of reforms to improve the safety and quality of nursing home care, hold nursing homes accountable for the care they provide, and make the quality of care and facility ownership more transparent so that potential residents and their loved ones can make informed care choices

Now, post-Covid, nursing home operators are railing against the forthcoming staffing mandate. Mark Parkinson, CEO and president of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), said: “Nursing homes are past the “nightmare” caused by Covid-19, but now are facing “a real business problem” that could be considerably worsened by the coming federal staffing mandate.” Bloomberg reported that nursing home are seeking latitutde on Staff Mandates. However, as recently as April 2023, nursing homes project gloom and doom as a result of staffing mandates. Axios reported: “We anticipate many nursing homes will be forced to further reduce their capacity and even close their doors if they are unable to meet these staffing mandates,” a letter the American Health Care Association and American Hospital Association send to CMS administrators Monday says. The nursing home industry projects mandated minimum standards would drive up nursing home costs by $10 billion annually.

Senate Democrats are not having it. They sent CMS a letter stating “Studies have shown a correlation between inadequate staffing levels and lower quality of care.” See J. Towhey, Senators push CMS to issue – and fund – federal home staffing mandate soon.

In my experience, families who’ve watched their loved ones left in poop and piss for hours, who’ve seen them suffer from dehydration and starvation because no one is available to assist with feeding or ensure food was eaten, or who’s seen other indignities, injuries or death as a result of neglect, have little sympathy for industry nay-sayers. And, as reported by the National Consumer Voice for Quality Long-Term Care, it is not at all certain nursing homes can’t afford to increase staff instead of staffing money in related party coffers.

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