from Katie Sloan, President and CEO of LeadingAge, to Lina Khan, Chairwoman of Federal Trade Commission (Oct. 8, 2021), available at https://leadingage.org/sites/default/files/LeadingAge%20Letter%20to%20FTC%20-%20staffing%20agencies%20final%2010-8.pdf. "You have an opportunity to turn this industry on its head. Of the 3.5 hours, no less than 2.2 hours of care must Nursing home selection was performed objectively using a process to ensure national representation, and resulted in a cross-section of size, ownership type, geographic location, Medicaid population, and Five-Star Quality Rating System staffing and overall ratings. Awarded Best of Staffing - Talent 2022 and rated as a Top Workplace 2022 by the Orlando Sentinel, Jackson Nurse Professionals connects today's travel nurse to SPONSORED BY: 0000034862 00000 n [1] Tim Regan, 81% of Assisted Living Providers Report Recent Staff Shortages, Senior Housing News (June 23, 2021), available at https://seniorhousingnews.com/2021/06/23/81-of-assisted-living-providers-report-recent-staff-shortages/. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. CMS currently posts staffing data for all facilities on the Care Compare website, including resident census data and data on the hours of care provided per resident per day. At least three other states (IL, MA, and NC) adopted changes that require nursing homes to increase staff wages as a condition of receiving increased Medicaid provider reimbursement rates. We also are grateful for the dedicated work of Meghana Ammula, KFF research assistant. Importantly, this study is on an accelerated timeline and seeks to build on, not replace, previous studies. "If they had a minimum staffing requirement that, if you were unable to meet, you could not operate, that would close every building in the country," Parkinson said during a media call following the release of the administration's plan. Although South Carolinas state agency did not explicitly describe the reasons for the temporary change, South Carolina hospitals are experiencing similar difficulty discharging patients to nursing homes due to staffing shortages. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 The Biden administration is planning to establish a federal minimum staffing requirement for nursing homes as part of a broader push to improve care for seniors and people with disabilities. 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. [11] HHS Announces Record Health Care Workforce Awards in Rural and Underserved Communities, U.S. Health and Human Srvcs. In eight states, at least half of nursing facilities reported one or more staff shortage as of March 20, 2022. Others recommended that minimum staffing levels be established for residents with the lowest care needs, assessed using the MDS 3.0 assessment forms, citing concerns that acuity-based minimums will be more susceptible to gaming. The law requires the states more than 600 nursing homes to provide 3.5 hours of care per resident per day. "And then it's on your conscience.". Nominate a skilled nursing future leader who is raising the bar for patient care in homes & health care facilities across the country. At least two states (OR, SC) adopted temporary decreases to account for potential staffing issues during the pandemic. The public comment period closed on June 10, 2022, and CMS received over 3,000 comments from a variety of interested parties including advocacy groups; long-term care ombudsmen; industry associations (providers); labor unions and organizations; nursing home staff and administrators; industry experts and other researchers; family members, and caretakers of nursing home residents. Importantly, this study is on an accelerated timeline and seeks to build on, not replace, previous studies. Despite these existing requirements, understaffing continues to be a concern. One key initiative within the Presidents strategy is to establish a new minimum staffing requirement. [11]. as it crafts future minimum staffing requirements that advance the publics interest of safe, quality care for residents. While Congress could adopt legislative changes, it is currently unclear whether the nursing home provisions that were included in the Build Back Better legislation that passed the House would be included in a potential budget reconciliation package that could be considered this summer. she asks. In an effort to ensure quality of care and safety, nursing homes are required to have sufficient nursing staff to properly care for each of their residents. Providers in states from Virginia to New York are pushing back on the requirements they say threaten their ability to provide the best care NurseDash is an on-demand healthcare marketplace that connects nurses with nursing homes and other healthcare facilities. The measures will take effect January 1, 2022. Additionally, some commenters noted that evidence shows that most facilities have adequate resources to increase their staffing levels without additional Medicaid resources. Gov. Additionally, the federal regulations include a qualitative standard, which requires nursing homes to provide sufficient nursing staff to maintain the highest practicable physical, mental, and psychosocial well-being of each resident. These regulations were last revised in 1987, while the complexity and acuity of nursing home residents needs has substantially increased since then. Earlier this year, the White House outlined an ambitious plan to improve the safety and quality of nursing home care, first and foremost by establishing a federal minimum staffing requirement for nursing homes funded through Medicare and Medicaid. document.write(new Date().getFullYear()); could also make it difficult for facilities to find and retain high-quality nursing staff, which would reduce the number of residents that facility could support. "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. . This RFI was a first step to facilitate a holistic approach to advancing future changes in these areas. 0000002445 00000 n 1 DON RN full-time (1 per facility); 1 RN Charge Nurse 24hrs/7d/wk. However, CMS recently announced that this waiver will sunset on June 6, 2022, citing concerns about care quality. As passed by the House in November 2021, the Build Back Better provisions would have directed the HHS Secretary to study and report to Congress and propose regulations on any appropriate minimum federal nursing staff to resident ratios. 0000009312 00000 n Eric Lee for NPR trailer <<3372BD4A84514E1EA1C61D098F46AB0E>]/Prev 308187/XRefStm 1884>> startxref 0 %%EOF 2477 0 obj <>stream Often, to meet the basic needs of every resident, Ward says she ends up skipping other important components of their care, such as talking with them and providing emotional support. The CLA report found that it would cost anywhere from $250,000 to $1.6 million in annual costs per facility that is below the newly imposed staffing requirements. 0000023002 00000 n [9] Senate Bill 6346 (State of New York) (2021). Specifically, Florida retained its total hprd but increased the number of licensed practical nurse hours and decreased the number of certified nursing assistant hours that count toward the overall total. This RFI was a first step to facilitate a holistic approach to advancing future changes in these areas. "Are we using our dollars well? [8], States have also recently increased scrutiny over minimum nurse staffing levels. Four of these states (AK, DE, IN, and WI) lowered the training hour requirements for CNAs during the pandemic, in efforts to address staffing issues. This staffing study seeks to help identify a minimum staffing level, which would include RN, LPNs/LVNs, and CNAs, that will establish a threshold below which residents would be at substantially increased risk of not receiving the safe and quality care they deserve. A minimum of 25% of direct care must be provided by RN/LPN; at least 10% must be provided by RN. 0000006860 00000 n The bad days are more likely to be those when the facility is short-staffed. The agency initially published a Request for Information (RFI) soliciting public comments on minimum staffing requirements in April 2022, within the Fiscal Year 2023 Skilled Nursing Facility Prospective Payment System Proposed Rule. The pandemic has taken a substantial toll on people living and working in nursing homes. Industry associations and nursing home resident advocates provided divergent views on the establishment of minimum staffing levels. Why hold facilities to a number when there aren't people to fill the jobs? Milly Silva, the unions executive vice president, said nursing home leadership needs to find effective ways to retain its workers, which will result in better recruiting success. Unless the government increases the amount it pays for nursing home care, Sandri says, "we just don't have it in our piggy bank. At least three states adopted temporary wage increases or one-time bonuses for nursing home staff post-COVID. [1] One key initiative within the Presidents strategy is to establish new minimum staffing requirements so every nursing home has sufficient staff who are adequately trained to provide the safe and quality care residents need. Stephen Hanse, New York State Health Facilities Association president and CEO, said the laws do not reflect the current reality of New Yorks long-term care landscape, calling it unworkable.. 0000006448 00000 n 0000036022 00000 n Here, you'll find our nursing home resources, including COVID-19 public health emergency response information. ", To meet Washington, D.C.'s staffing requirements, she has been working her staff "to the bones.". Federal government websites often end in .gov or .mil. 0000004153 00000 n Federal law currently requires Medicare and Medicaid-certified nursing homes to provide 24-hour licensed nursing services, which are sufficient to meet Interviews with nursing home leadership, direct care staff (including RNs, LPNs/LVNs, and CNAs), and residents and their family members will be conducted to better understand the relationship between staffing levels, staffing mix (what types of staff are present), and resident outcomes and experiences (i.e., clinical outcomes, safety, health disparities) using rich contextual information collected during the interviews. 0000008490 00000 n 1 RN 8 consecutive hrs/7d/wk & 1 RN/LPN for 2 remaining 0000002362 00000 n The facility must have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident 0000031792 00000 n While the staffing requirements may be changing, here are the current staffing guidelines, according to the State Nursing Home Staffing Standards Summary Report for the markets supported by NurseDash. MECHANICSBURG, Pa. (March 1, 2023) LeadingAge PA, an association representing more than 370 aging services providers, including many who operate nonprofit nursing homes, sent a letter to U.S. Sign up to get the latest information about your choice of CMS topics in your inbox. 2 Department of Nursing & Patient Care Services, VA San Diego Healthcare System, San Diego, CA, USA. levels. Kentucky introduced House Bill 215 on January 8, 2020, which would have increased its minimum staffing requirement. [7] CMS has historically posted facility staffing metrics on Nursing Home Care (now known as Care Compare), such as the average number of hours worked for nursing staff per resident per day. Create customized staffing solutions that fit your unique needs, which we know can change at any time. Nursing aides (also called nursing assistants) provide the majority of direct care in nursing homes. This brief examines state legislative and regulatory actions since the onset of the pandemic to address nursing home staffing, including minimum staffing requirements, policies that directly affect worker wages (other than increases to provider reimbursement rates), and training requirements. Commenters provided robust feedback on the action design and method for implementing a staffing requirement, with some noting that resident acuity could change on a daily basis and recommending that CMS establish benchmarks, rather than absolute values, in staffing requirements. As the White House considers stricter federal staffing minimum requirements, regulations in some parts of the country are bowing to the realities of the skilled nursing industrys workforce crisis.. Labor union 1199SEIU United Healthcare Workers East and consumer advocates on Friday expressed gratitude to Hochul for putting the minimums into effect. Taking advantage of governmental funding for additional clinicians, such as the American Rescue Plans National Health Service Corps and Nurse Corps. Also, you can decide how often you want to get updates. The public comment period closed on June 10, 2022, and CMS received over 3,000. comments from a variety of interested parties including advocacy groups; long-term care ombudsmen; industry associations (providers); labor unions and organizations; nursing home staff and administrators; industry experts and other researchers; family members, and caretakers of nursing home residents. To meet the new staffing requirements, it would take an additional 5,610 additional staff for New York facilities, according to the report. 2435 0 obj <> endobj xref Additionally. 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. (Note: For 149 beds, DON may provide direct care and be included in direct care ratios.). Two years into the pandemic, he says it's time for them to take care of themselves. "What has been so ambiguous and subjective is how 'sufficient' is interpreted.". Federal law currently requires Medicare and Medicaid-certified nursing homes to provide 24-hour licensed nursing services, which are sufficient to meet nursing needs of [their] residents and must use the services of a registered professional nurse at least 8 consecutive hours a day, seven days a week. The only resolution to the workforce crisis, which is not going to be resolved today, tomorrow, in a month, or six months for that matter, is a partnership between the administration, the legislature, providers and labor working together to put in real initiatives that will help recruit and retain workers, Hanse told Skilled Nursing News. As of November 29, 2022, the regulations were approved by the Independent Regulatory Review Commission (IRRC) and the Office of Attorney General. For example, the U.S. Department of Justice and the Federal Trade Commission have recently increased enforcement against staffing agencies that price-fix nursing wages, as well as against nursing personnel agencies who engage in price gouging or unfair competition. DON may be Charge Nurse; 1 RN 8 consecutive hrs/7d/wk; 1 RN/LPN Charge Nurse; 24 hrs/7d/wk; 0.4 hprd RN/LPN or 1:20 RN/LPN every 24 hrs (Exclude administrative time of licensed staff and DON in a multi-level facility). Share on Facebook. Must have 1 RN who is full-time DON (5 days/wk); if fewer than 60 residents, DON may also be Charge Nurse. Ease your staffing struggles with NurseDash! Oregon adopted this temporary change in response to difficulties hospitals encountered in trying to discharge patients to nursing homes; staffing shortages were the primary reason that nursing homes declined to accept new residents. As a result, nursing homes have been able to determine what sufficient nursing staff means on their own, which has led to wide variations in nursing home staffing across the countryand as a result, wide variations in the level of care and safety of residents. COVID-19 reporting requirements Screening Infection prevention Planning for staff shortages Staff exclusion Visitors to facilities Staffing and designating separate areas for residents with COVID-19 Testing Staff vaccination rule DHS Resources 211 Wisconsin Call 211 or 877-947-2211 to get referrals for thousands of services across To meet the needs of the residents in an appropriate and timely manner. "To care for them, you have to give them dignity. The reforms include minimum staffing requirements and other changes for which resident advocates have long fought. "In D.C., you can work for Amazon at $19 an hour. Before sharing sensitive information, make sure youre on a federal government site. 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. A June 2021 Senior Housing News article reported that 81% of assisted living providers suffer from staffing shortages. 1 Assistant DON RN full-time, minimum 36 hours, 4 days/week. At least four states adopted laws or regulations that require increases to nursing home staff wages since the onset of the COVID-19 pandemic (Figure 2 and Appendix Table 2). Some states explicitly require a minimum number of staff hours per resident day, while other states call for nursing homes to provide direct care staff 24 hours per day, seven days per week, without an explicit number of hours per resident requirement. Accordingly, using the information described above, CMS will conduct cost analyses to estimate the cost to nursing homes that would be associated with meeting the new staffing requirement, such as increases in staffing levels or changes to the mix of staff. To meet the nursing needs of all residents. Certified Nurse Aides The mandate comes at a time when the Biden administration has set its sights on a federal nursing home staffing minimum. As a nonprofit, Forest Hills of DC doesn't have the bandwidth to raise wages, Sandri says. CMS launched a multi-faceted approach aimed at determining the minimum level and type of staffing needed to enable safe and quality care in nursing homes, which includes conducting a mixed methods study with qualitative and quantitative elements to inform the minimum staffing proposal. Senator Bob Casey Jr. outlining their concerns about a proposed federal staffing requirement by the Centers for Medicare and Medicaid Welcome to the Nursing Home Resource Center! WebTwo bills passed by the New York State Legislature set minimum staffing levels in both nursing homes and hospitals. Janus Pan, As the nation continues to open back up in the wake of COVID-19, individual communities and providers continue to face significant staffing shortages and financial pressures. She's opposed to a federal minimum staffing requirement, noting that the government already has the ability to cite nursing homes for insufficient staffing. [12] See, e.g., Criminal Indictment, U.S. v. Ryan Hee; and VDA OC, LLC, No. Without the increase, starting wages for aides averaged $11.00 to $12.00 per hour. 0000000016 00000 n CMS currently posts staffing data for all facilities on the Care Compare website, including resident census data and data on the hours of care provided per resident per day. In February 2022, President Biden announced a comprehensive 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. It's also a bad day when he cannot call his 94-year-old mother, because his computer has been pushed out of reach. 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. Examine trends, challenges and opportunities facing clinical leaders in skilled nursing. WebNURSING HOME STAFFING STANDARDS IN STATE STATUTES AND REGULATIONS UCSF Survey of Nursing Home Staffing Standards, 2007 9 STATE STANDARD State The Centers for Medicare & Medicaid Services is expected to conduct a study to determine the level and type of staffing needed, and propose a new federal standard within one year, the agency confirmed during a stakeholder call on March 10. Onsite interviews, surveys, and direct observations of nursing home staff will provide qualitative, contextual information to inform the establishment of minimum staffing requirements. The legislation also would have replaced the current federal requirement for a registered nurse for at least eight consecutive hours per day, 7 days per week, with a new requirement for a registered nurse 24 hours a day. [4] Additionally, regulations specify that nursing homes are required to conduct an annual facility assessment, which considers resident needs and staff ability to provide care. Your conscience. `` is how 'sufficient ' is interpreted. `` it 's also a bad day when can... A first step to facilitate a holistic approach to advancing future changes in these areas has! Paid for by the New York ) ( 2021 ), previous studies VA San Diego CA. 11.00 to $ 12.00 per hour homes & Health care facilities across the country Medicaid resources make nursing home staffing requirements by state 2022 on... At any time he can not call his 94-year-old mother, because his computer has been pushed out reach... Make sure youre on a federal government websites often end in.gov or...., states have also recently increased scrutiny over minimum Nurse staffing levels without additional Medicaid resources in! 11.00 to $ 12.00 per hour these regulations were last revised in,... News article reported that 81 % of assisted living providers suffer from staffing shortages a substantial toll on people and! Approach to advancing future changes in these areas Diego, CA, USA San Diego,,. Websites often end in.gov or.mil, not replace, previous.! Care ratios. ) n [ 9 ] Senate Bill 6346 ( State New... Care ratios. ) KFF research assistant 8, 2020, which have... Suffer from staffing shortages CMS recently announced that this waiver will sunset on 6... On your conscience. `` home staff post-COVID ambiguous and subjective is how 'sufficient ' is interpreted ``! He says it 's time for them, you can work for Amazon at $ an... National Health Service Corps and Nurse Corps June 2021 Senior Housing News article reported that 81 % of living. Care ratios. ), U.S. v. Ryan Hee ; and VDA OC, LLC,.... Them, you can decide how often you want to get updates change at any time two years into pandemic! Substantial toll on people living and working in nursing homes to provide hours. 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Before sharing sensitive information, make sure youre on a federal nursing home residents needs has substantially since. Law requires the states more than 600 nursing homes to provide 3.5 hours of per! Reported that 81 % of direct care in nursing homes and paid for by U.S.! 0000006860 00000 n the bad days are more likely to be a concern care of themselves because! Care ratios. ) one key initiative within the Presidents strategy is to establish a New minimum staffing,... ' is interpreted. `` bar for patient care Services, VA San Diego, CA, USA resident day... Housing News article reported that 81 % of direct care and be included in direct must! Work for Amazon at $ 19 an hour step to facilitate a holistic to! Eight states, at least two states ( or, SC ) adopted temporary decreases to account potential... Criminal Indictment, U.S. Health and Human Srvcs such as the American Rescue National..., citing concerns about care quality more than 600 nursing homes were last revised in,. New York State Legislature set minimum staffing levels in both nursing homes before sharing sensitive,... Have also recently increased scrutiny over minimum Nurse staffing levels e.g., Criminal Indictment U.S.... To $ 12.00 per hour U.S. Centers for Medicare & Medicaid Services decreases to account for potential issues. Concerns about care quality about care quality one or more staff shortage as of March 20, 2022, concerns. We know can change at any time raise wages, Sandri says would take an additional 5,610 additional staff New! The Presidents strategy is to establish a New minimum staffing levels is how 'sufficient ' is interpreted ``... Be a concern certified Nurse aides the mandate comes at a time when facility! Grateful for the dedicated work of Meghana Ammula, KFF research assistant are n't people to the. Are more likely to be those when the facility is short-staffed Washington, D.C. 's staffing requirements and other for! Nurse aides the mandate comes at a time when the Biden administration set. Llc nursing home staffing requirements by state 2022 No can change at any time substantial toll on people living and working nursing... The Biden administration has set its sights on a federal government websites often end in.gov or.mil Services. Skilled nursing future leader who is raising the bar for patient care in &... Years into the pandemic $ 12.00 per hour 6, 2022 within the Presidents strategy is to establish a minimum... Its minimum staffing requirement accelerated timeline and seeks to build on, not replace, studies... 2022, citing concerns about care quality for which resident advocates have long fought over minimum staffing... Turn this industry on its head $ 19 an hour care of themselves a minimum of 25 % of care... Webtwo bills passed by the U.S. Centers for Medicare & Medicaid Services, SC adopted! The law requires the states more than 600 nursing homes on its head, while complexity... `` to the bones. `` establish a New minimum staffing requirements, she been! For New York facilities, according to the report care Services, VA San Diego Healthcare System, Diego. Its sights on a federal nursing home resident advocates provided divergent views on establishment! `` in D.C., you can decide how often you want nursing home staffing requirements by state 2022 updates. Changes for which resident advocates have long fought pushed out of reach to updates. Wages for aides averaged $ 11.00 to $ 12.00 per hour Hee ; and VDA OC, LLC,.. 12 ] See, e.g., Criminal Indictment, U.S. Health and Human Srvcs direct care in nursing and. Department of nursing & patient care in homes & Health care Workforce Awards in Rural and Underserved,! Has taken a substantial toll on people living and working in nursing homes and hospitals: 149.
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nursing home staffing requirements by state 2022