Guidance on staffing measures tied to the five-star rating system was released on Thursday – the Centers for Medicare & Medicaid Services (CMS) updated its staffing measures to include three on staffing levels and three on staff turnover.
Total nurse staffing hours per resident per day on weekends, in addition to previously announced nurse turnover within a given year, annual registered nurse turnover and annual number of administrators who left the sector will be incorporated into staffing measures.
The agency specified a maximum of 100 points can be awarded for case-mix adjusted total nurse staffing and RN staffing, 50 points max for weekend statistics, and 50 points each for annual total nurse turnover, RN turnover and administrator turnover, respectively.
The five-star “stool” is made up of three legs, including staffing, quality and regulatory measures. Historically, regulatory measures have been the most weighted, followed by staffing and then quality.
Turnover measures won’t be reported or used in the staffing rating if quarterly data is missing or invalid, CMS said in its guidance, and won’t be included in the turnover measure calculation period for six quarters.
Operators and nursing home industry leaders have been waiting for guidance on the new measures, especially how much weight each aspect would get on a facility’s overall score.
Generally, the additions have been seen by some as insensitive in light of a historic staffing shortage and soaring agency use.
