The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), has issued a proposal to establish additional staffing requirements for nursing homes. If approved, the proposal would implement national minimum nurse staffing standards. Nursing homes participating in Medicare and Medicaid would be required to provide residents with at least 0.55 hours of care from a registered nurse each day. This standard exceeds current standards in almost all states. In addition to providing this level of care to residents, nursing homes would also be required to have a registered nurse on site 24/7 and provide staffing that “meets the needs of residents.” This may require nursing homes to maintain levels of staffing above the proposed minimum standard in order to comply with the proposed rule. CMS estimates that approximately 75 percent of nursing homes would need to hire additional staff to meet the proposed standards.

The proposal would also require states to collect data and report on compensation for workers in nursing homes and intermediate care facilities in connection with recent CMS proposals to publish Medicaid data on average hourly pay rates for home care workers. CMS has also announced that it will work with the Health Resources and Services Administration (HRSA) to provide financial incentives such as scholarships and tuition reimbursement to build the nursing workforce and support staffing in nursing homes.

CMS and the HHS Office of Inspector General (HHS-OIG) also announced upcoming efforts to enforce existing standards and increase accountability. The announcements include: increased audits of nursing home staffing, a higher level of scrutiny in the analysis of state inspection findings to ensure that citations are applied consistently, additional oversight on nursing homes’ Medicare and Medicaid spending, increased oversight on the prescribing of antipsychotic drugs to nursing home residents, and efforts to improve nursing home safety during natural disasters and other emergency situations.

The attorneys at Nicholson & Eastin, LLP routinely advise clients in Medicare and Medicaid compliance matters. If you are seeking advice regarding the potential impact of this CMS proposal on nursing home staffing standards, or have questions regarding any other aspect of the proposal, please do not hesitate to contact the attorneys at Nicholson & Eastin.

The full text of the proposed rule is available at https://www.federalregister.gov/public-inspection/current, and further details regarding the minimum staffing standards are available at https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid