CMS Releases Nursing Home Staffing, Census Data to Help States Make PPE and Testing Decisions

The Centers for Medicare & Medicaid Services (CMS) on Friday released a public database of staffing and resident counts for nearly 15,000 nursing homes, with the goal of potentially helping states make more informed decisions about the distribution of personal protective equipment (PPE) amid the COVID-19 pandemic.

Using fourth-quarter 2019 data from the Payroll-Based Journal (PBJ) system, CMS compiled a spreadsheet that includes a variety of staffing information about each facility, including average daily nursing headcount, average daily overall staffing totals, the number of certified beds, and the average resident census.

“We believe this information can be used to identify approximate facility needs, and help support local, state, and federal agencies’ response to preventing and controlling the transmission of COVID-19,” CMS official David Wright wrote in a Friday memo to State Survey Agency (SSA) directors. “For example, this could be used to help state agencies where, and how much, personal protective equipment (PPE) and testing should be directed within their state.”

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Wright also noted that the data may not necessarily reflect the current situation in nursing homes, particularly given the upheaval of COVID-19.

Census information has always been available on the consumer-facing Nursing Home Compare website, Wright noted, but Friday’s release marks the first time that data on individual facility staff levels has been made public.

On average, the nation’s nursing homes have 41 nursing employees and 60 total workers on site every day, with a daily census of 87 residents — against a total of 107 beds.

“This action bolsters CMS’s response to COVID-19 and reinforces our commitment to transparency,” Wright noted.

LeadingAge, an organization that represents non-profit senior living and care operators across the country, praised CMS’s decision.

“We are encouraged by the mention about using PBJ data to determine PPE needs,” LeadingAge president and CEO Katie Smith Sloan said in a statement. “We hope this results in appropriate amounts of PPE for nursing homes who need it urgently.”

The updated memo also clarified that operators are allowed to use civil monetary penalty (CMP) funds to purchase communication devices — such as tablets and webcams — that residents can use to stay in touch with their families.

CMS additionally noted that while the federal government will on April 29 begin posting the results of inspections conducted after the agency suspended non-emergency surveys last month, those results will not affect buildings’ individual star ratings.

“Due to the March 23rd targeted inspection plan, there is a great shift in the number of nursing homes inspected, and how the inspections are conducted,” Wright wrote. “This would disrupt the inspection domain of the Nursing Home Five Star Quality Rating System because many nursing homes that would normally be inspected, will not, thereby over-weighting and impacting the ratings of those facilities that are inspected. This could then potentially mislead consumers.”

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