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Capitol Correspondence - 09.12.23

New Nursing Home Minimum Staffing Standards Proposed by CMS

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The Centers for Medicare & Medicaid Services (CMS) has proposed new regulations aimed at improving the quality of care in nursing homes across the United States. Among other provisions, the proposed rule focuses on three core staffing proposals.

1. Minimum Nurse Staffing Standards: CMS is proposing minimum nurse staffing standards in long-term care (LTC) facilities. The proposed standards include 0.55 hours per resident day (HPRD) for Registered Nurses (RNs) and 2.45 HPRD for Nurse Aides (NAs). These thresholds are considered the minimum baseline levels, and CMS encourages facilities to staff above these levels based on the needs of their residents.

2. 24/7 RN On-Site Requirement: To ensure round-the-clock access to qualified nursing care, CMS is proposing a requirement for LTC facilities to have an RN on-site 24 hours a day, seven days a week. This move aims to address safety concerns, especially during evenings, nights, weekends, and holidays.

3. Enhanced Facility Assessment Requirement: CMS is strengthening the facility assessment requirement, emphasizing evidence-based methods for care planning, individual resident assessments, and the input of facility staff. The goal is to create thoughtful, person-centered staffing plans that adapt to resident needs and ensure quality care.

The proposed rule also includes provisions to enhance public transparency regarding Medicaid payments for services in nursing facilities and intermediate care facilities for individuals with intellectual disabilities. This reporting requirement intends to shed light on compensation for direct care workers and support staff.


Comment Submission: This proposed rule is open for public comment for a 60-day period, ending on November 6, 2023. Stakeholders, including advocacy groups, providers, and the general public, are encouraged to provide feedback on these critical changes to nursing home staffing standards.

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