Long-Term Care Facilities: Are You Ready for New CMS Staffing Standards and Transparency?
By Marisol Cooke
Director
Health Care Consulting Practice, Moss Adams
Original Publish Date: November 5, 2024
The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (final rule) that went into effect on June 21, 2024. This rule is intended to establish minimum staffing standards for long-term care (LTC) facilities as part of the Biden-Harris Administration's nursing home reform initiative to ensure safe and quality care in LTC facilities.
The rule also requires states to report the percent of Medicaid payments for certain Medicaid-covered institutional services that are spent on compensation for workers and support staff.
The rule represents a pivotal change in LTC staffing standards and underscores a profound shift towards a holistic and person-centered care for residents. Use the following insights to help your organization comply with these new standards.
Background
Based on a study by Kaiser Family Foundation (KFF), just 60% of facilities currently meet the overall staffing requirements of 3.48 hours per resident a day, but fewer facilities meet the final requirements that include minimums for registered nurses and nurse aids.
The study also found nursing facilities are hiring more than 80,0777 nurse aids and 22,077 registered nurses. These statistics reveal the urgency of the situation and potential compliance repercussions.
New Staffing Requirements
With a focus on not just meeting the bare minimums, but on the presence of skilled nursing professionals around the clock, the mandate recognizes the crucial role of registered nurses in safeguarding a resident’s well-being.
The new rule requires the following standards for nurse staffing:
- Minimum 3.48 hours per resident a day total direct nursing care to residents
- A registered nurse on staff 24 hours per day, 7 days per week
Exceptions to Implementation Effective Date of July 21, 2024
The regulations must be implemented on the effective date, except for the following:
Compliance Strategies
Maintaining compliance with the new LTC staffing standards is crucial for providing safe and high-quality care to residents. Here are strategies that facilities should consider:
- Revisit Internal Policies. Review and update your facility’s internal guidelines to reflect the new requirements.
- Conduct Annual Risk Assessments. Regularly assess staffing needs and identify gaps.
- Foster Relationships with Contracting Partners. Collaborate with partners to close staffing gaps.
- Seek Alternative Funding. Explore funding options to support staffing efforts, such as grants.
Next Steps
Incorporating input from residents, families, and healthcare professionals, alongside the adoption of SMART goals and leveraging technology can shift your facility to a more personalized and efficient care paradigm. This multifaced approach acknowledges the complexities of modern healthcare delivery while striving for optimal outcomes for those entrusted to nursing home care.
We’re Here to Help
For more information on the CMS’s new staffing standards and LTC strategies that can help keep your organization in compliance, contact your Moss Adams professional.
Additional Resources