Based on the federal government's 5-star rating system for nursing homes from November 2022, Hawaii has the best average score (3.90 across 41 facilities), followed by Alaska (3.80, 20 facilities), Idaho (3.46, 78 facilities), Delaware (3.35, 43 facilities), and Utah (3.34, 96 facilities). While there are a variety of opinions among stakeholders on establishing minimum staffing requirements, it is CMS goal to consider all perspectives, as well as findings from the staffing study, as it crafts future minimum staffing requirements that advance the publics interest of safe, quality care for residents. 5376 (117th Congress) (2021-2022). Turnover at her facility, home to about 100 residents, is nearly triple what it was before the pandemic. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 While federal requirements state that facilities must maintain sufficient nursing staff to meet residents needs, specific guidelines are not set and state regulations vary drastically. hide caption. Skilled Nursing News "It's so that each person gets exactly what they need to be the best they can be and live their best life," says Robyn Grant, director of public policy and advocacy at the Consumer Voice, a group focused on long-term care. 0000035796 00000 n Stories like Miller's and far worse have pushed the Biden administration to call for major reforms in nursing homes. One after another. Sign up to get the latest information about your choice of CMS topics in your inbox. This effort includes issuing a Request for Information (which occurred earlier this year as a part of the Fiscal Year 2023 Skilled Nursing Facility Prospective Payment System Proposed Rule[3]) and conducting a new study. Home Blog New Nursing Home Minimum Staffing Requirements By State for 2023. rV3f2cP!aOI4XX\f3 "c:C]'5x ?(0}CP uzHq8A,7wvVSg`wg 2L@zK2(I~@Za,3X6}z` 7s endstream endobj 2476 0 obj <>/Filter/FlateDecode/Index[154 2281]/Length 67/Size 2435/Type/XRef/W[1 1 1]>>stream The Biden Administration recently announced plans to propose new federal minimum staffing adequacy regulations in the next year. "They're tired. On bad days, something goes wrong and it takes awhile before someone is available to respond to his call button sometimes 45 minutes or longer. Yet, a recent report concluded that staffing standards in almost every state remain severely low. In April 2022, the National Academies of Science, Engineering, and Medicine recommended minimum staffing levels, policies to ensure competitive wages and benefits, and improvements to staff training and opportunities for career advancement, among other reforms, as part of its comprehensive report to improve nursing home quality. Nursing homes across the state of New York must now abide by a new law that requires facilities to meet minimum staffing levels after Gov. Eric Lee for NPR The law requires every facility to maintain daily staffing hours equal to 3.5 hours of care per resident per day by a certified nurse aide, licensed practical nurse or registered nurse. "In D.C., you can work for Amazon at $19 an hour. Brooks-LaSure says her agency will determine how much staff nursing homes should be required to have and then enforce that through a rule. [6], Furthermore, CMS has increased its reporting requirements for nursing homes, public posting of facility staffing measures, and enforcement penalties for nursing homes that do not comply with staffing requirements. 0000008976 00000 n Quantitative analysis will use secondary data, including Medicare Payroll-based Journal (PBJ) data, Minimum Data Set (MDS), and Medicare claims. 1 RN 8 consecutive hrs/7d/wk & 1 RN/LPN for 2 remaining 0000035309 00000 n It means that you have to confront issues around wages, issues around benefits, issues around working conditions and what it means to have a safe working environment for the caregivers.. 2435 43 Read on to learn more about the new nursing home minimum staffing requirements and the effect they could have on facilities. Detailed state-level information is included in the Appendix Tables. hide caption. Skilled Nursing News is the leading source for news and information covering the skilled nursing industry. 0000002445 00000 n Importantly, this study is on an accelerated timeline and seeks to build on, not replace, previous studies. When Jordyn's not covering the latest skilled nursing news, she's likely catching a Cubs game at Wrigley Field, cheering on the Iowa Hawkeyes or watching Gilmore Girls all the way through for the millionth time. [12] Going forward, providers would be well-served to keep in mind these and any other regulatory staffing requirements. A December 2021 study reviewed state nursing home staffing standards and concluded that staffing standards in almost every state remain severely low. The Medicaid and CHIP Payment and Access Commission (MACPAC) recently reviewed state policies that can help address staffing issues, including increasing Medicaid payment rates, changing Medicaid payment methods to incentivize facilities to devote more revenue to staff, and requiring minimum staffing levels above the federal standard. Opens in a new window. Nursing Home Staffing Study Stakeholder Listening Session-August 29, 2022. Evidence has shown that adequate staffing is closely linked to the quality of care residents receive. 0000031451 00000 n She's opposed to a federal minimum staffing requirement, noting that the government already has the ability to cite nursing homes for insufficient staffing. The reforms include minimum staffing requirements and other changes for which resident advocates have long fought. Eric Lee for NPR CMS appreciates the interest shown by so many stakeholders to date during the RFI process and looks forward to further engagement on this issue. Skilled nursing facilities provide round-the-clock assistance with healthcare and activities of daily living. In January 2022, CMS began posting data on the level of weekend resident nurses, total nurse staffing, and staff turnover for all nursing homes on the Care Compare website. Initial visits to 50 out of the 75 nursing homes will provide important information to guide the development of the proposed minimum staffing standards, and visits to the remaining 25 facilities will help validate the initial findings as part of CMSs iterative policy process. Among the states that adopted increases, the amount ranged from an additional 0.16 hprd in Connecticut to an additional 3.78 hprd in Rhode Island. In Virginia, House Bill 646 would require the state Board of Health to establish a minimum of 2.8 hours direct care per resident per day for nursing aide staff, and at While we reviewed legislation and regulations in all 50 states and DC, this brief may not capture all relevant policy changes. According to Genworths 2018 Cost of Care Survey, assisted 0000012942 00000 n KFF appreciates the contributions of Emma Childress, law/master of health administration student at St. Louis University, and Belle Harris, law student at Georgetown University, who worked as contractors on this project. The study team is currently reviewing existing literature to summarize the evidence of the relationship between minimum staffing in nursing homes and the safety and quality of care, as well as clarify the relative strengths and weaknesses of the available literature. Or when he misses his wheelchair time because there aren't enough staff to lift him out of bed. An official website of the United States government. Without the increase, starting wages for aides averaged $11.00 to $12.00 per hour. All rights reserved. Taking advantage of governmental funding for additional clinicians, such as the American Rescue Plans National Health Service Corps and Nurse Corps. hA 04Pk\GczC. As a nonprofit, Forest Hills of DC doesn't have the bandwidth to raise wages, Sandri says. Federal regulations require nursing aides to complete a 75-hour training program and to pass a competency evaluation in order to work in a nursing home longer than four months. Additionally, some commenters noted that evidence shows that most facilities have adequate resources to increase their staffing levels without additional Medicaid resources. Commenters offered recommendations for implementing minimum staffing requirements. Nursing Home Staffing Study Stakeholder Listening Session-August 29, 2022 In February, the Biden Administration announced a comprehensive set of reforms to Finally, CMS received comments on the cost impacts of establishing staffing requirements, payment, and study design. 2.5 hprd by CNA, not below 1:20 CNA to resident ratio. The Department of Social Services has made funding available to nursing homes to meet the staffing requirements. Federal government websites often end in .gov or .mil. [12] See, e.g., Criminal Indictment, U.S. v. Ryan Hee; and VDA OC, LLC, No. Welcome to the Nursing Home Resource Center! May provide direct care and be counted in direct care ratios. ". Other states may have adopted or proposed Medicaid provider reimbursement rate changes that do not explicitly require corresponding increases in direct care staff wages. However, there has never been a federally required minimum number of staffing hours per resident day, despite repeated calls to establish one from researchers and patient advocates over the last several decades. CMS also received comments on factors impacting facilities ability to recruit and retain staff, with most commenters in support of creating avenues for competitive wages for nursing home staff to address issues of recruitment and retention. ", To meet Washington, D.C.'s staffing requirements, she has been working her staff "to the bones.". Maryland, where Ward works, actually does have a minimum staffing requirement for nursing homes, as do most states. Must have 1 RN who is full-time DON (5 days/wk); if fewer than 60 residents, DON may also be Charge Nurse. [1] A September 2021 survey by the American Health Care Association and the National Center for Assisted Living showed that 86% of nursing homes and 77% of assisted living providers said their workforce situation has gotten worse over the three months preceding the survey. What will the staffing study look like? 26, 2021); Ltr. 0000054667 00000 n [4] H.R. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. 1 Department of Social & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA. "It's a bad day when I'm in pain, and I'm not going to get relief in a timely fashion," says Miller, who describes himself as a functional quadriplegic. Four out of 5 who initially express interest in a job don't come in for interviews. 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