Nursing home minimum staffing requirements has been a hot topic for the industry from the moment the initiative was introduced by the Biden administration back in February.
After soliciting feedback through a request for information (RFI) on the topic back in April as part of the proposed rule, the Centers for Medicare & Medicaid Services (CMS) received more than 3,000 comments on the issue.
Parties including advocacy groups, long-term care ombudsman, industry associations, labor unions and organizations, nursing home staff and administrators, industry experts and other researchers and family members and caretakers of nursing home residents, were among the commenters.
Overall, the government agency received “mixed feedback” on establishing minimum staffing requirements for long-term care facilities, according to CMS Policy Analyst Cameron Ingram.
“Nursing home advocacy groups and family members of residents are supportive of establishing minimum staffing requirements, whereas industry and provider groups expressed concern,” Ingram said on Thursday during an industry open door forum call.
While there were clear differences of opinion among stakeholders regarding the implementation of minimum staffing requirements, Ingram said CMS’s goal is to use this information, along with its staffing study, “to strike a balance between the positions” and ensure safe and quality care for residents.
Commenters offered recommendations on how to implement the mandate, such as a focus on an acuity staffing model per shift instead of an across the board staffing requirement, she said.
One of the biggest challenges brought up when discussing the idea of a minimum staffing mandate is the ongoing workforce shortage facing nursing homes across the country.
The sector has lost 241,000 workers since the start of the pandemic — the worst among their health care peers — and has yet to fully recover.
That being said, most stakeholders were in support of creating avenues for competitive wages for staff with the goal of addressing recruitment and retention issues, Ingram said on the call.
CMS leaders have previously said the agency is using a “multi-faceted” approach in proposing the ratio — stakeholder commentary, a long-awaited study and listening sessions to be held this month.
Evan Schulman, CMS division of nursing homes director, said last month that the agency is acting now on a minimum staffing ratio, along with other staffing-related updates, because it’s been proven that staffing impacts quality.
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