Qualified Care Facilities (SNFs) and Care Facilities (NPs) must meet the requirements of Subpart B of 42 CFR Part 483 to receive payments under the Medicare or Medicaid programs. To certify an SNSF or SNSF, a state assessor conducts at least one investigation into the Personal Safety Code (LSC) and one standard survey. The CMS regional office determines an entity`s eligibility to participate in Medicare based on an institution`s certificate of compliance and compliance with civil rights requirements. Despite these existing requirements, staff shortages remain a problem. For this reason, CMS considers it essential for patient safety that it implements the new regulation in order to set more specific, detailed and quantitative minimum staffing requirements. What did CMS learn from the request for information? The agency initially issued a Request for Information (RFI) in April 2022 to solicit public comment on minimum staffing requirements under the prospective payment system for the qualified care facility proposed in fiscal 2023. The feedback received has been and will be used to inform the design of the research study and proposals regarding the minimum need for direct nursing staff in nursing homes in 2023. This DDR was a first step towards a holistic approach to driving future change in these areas. The public comment phase ended on the 10th.

June 2022, and CMS received more than 3,000 comments from a variety of stakeholders, including stakeholders; Ombudsmen for Long-Term Care; Industry associations (suppliers); trade unions and organizations; nursing home staff and administrators; industry experts and other researchers; Family members and caregivers of nursing home residents. While there is a variety of views among stakeholders on the establishment of minimum staffing requirements, the CMS`s objective is to consider all perspectives as well as the results of the staffing study as it creates future minimum staffing requirements that promote the public interest in safe, high-quality care for residents. On-site interviews, surveys and direct observations of nursing home staff provide qualitative and contextual information to inform the establishment of minimum staffing requirements. Interviews with nursing home management, direct nurses (including RNs, RPNs and CNAIs) and residents and their family members are conducted to better understand the relationship between staffing, staff composition (what types of staff are present) and resident outcomes and experiences (i.e., clinical outcomes, safety, health differences), using detailed contextual information provided during interviews. Collected. In addition, observational data is collected on-site from trained clinicians who observe and record time spent on care, including the concern to distinguish time spent on care from time spent on administrative care. These data will allow the development of a simulation model to study the effects of different levels of staffing and patient sharpness on the quality and timeliness of care. This simulation model is important to ensure that the staff study reflects not only the number of employees currently available as a descriptive model, but also the number of staff members required for safe, high-quality care for patients of varying degrees of severity. Learn more about documentation requirements and how to prevent claims from being rejected. Finally, the CMS received comments on the financial implications of identifying staffing requirements, compensation and study design. Others pointed to the variability in Medicaid work reimbursement from state to state, suggesting that Medicaid rates in many states are not keeping pace with rising labor costs. Commenters provided strong feedback on the design of measures and the methodology for implementing a staffing need, with some noting that resident acuity could change on a daily basis, and recommended that the CMS establish benchmarks rather than absolute values for staffing needs.

The CMS currently publishes staff data for all facilities on the Care Compare website, including resident census data and hours of care data per resident per day. [5] Some states may also have minimum staffing requirements for nursing homes.