Trump Administration Strengthens Nursing Home Oversight and Safety to Ensure Adequate Staffing

The following message was released on November 30, 2018, by the Centers for Medicare & Medicaid Services (CMS), a division of the Department of Health and Human Services, announced actions that will bolster nursing home oversight and improve transparency in order to ensure that facilities are staffed adequately to provide high-quality long term care. These actions include sharing data with states when potential issues arise regarding staffing levels and the availability of onsite registered nurses; clarifying how nursing home facilities should report hours and deduct time for staff meal breaks; and providing long term care facilities with new tools to help ensure their resident census is accurate.

“CMS takes very seriously our responsibility to protect the safety and quality of care for our beneficiaries,” said CMS Administrator Seema Verma. “Today CMS is taking important steps to protect nursing home residents based on potential risks revealed by new payroll-based staffing data that our Administration released. We’re deeply concerned about potential inadequacies in staffing, such as low weekend staffing levels or times when registered nurses are not onsite, and the impact that this can have on patient care. The actions announced today strengthen our oversight of resident health and safety, and help ensure accurate public reporting.”

Research shows the ratio of nurses to residents impacts quality of care and health outcomes. For example, facilities with higher nurse staffing levels tend to have fewer resident hospitalizations.  In general, the new payroll-based staffing data shows most facilities have somewhat fewer staff on weekends, but some facilities have significantly lower weekend staffing. Additionally, some facilities have reported days with no registered nurse onsite, although nursing homes are generally required by law to have a registered nurse onsite eight hours a day, seven days a week.

To help address these risks, CMS will use frequently-updated payroll-based data to identify and provide state survey agencies with a list of nursing homes that have a significant drop in staffing levels on weekends, or that have several days in a quarter without a registered nurse onsite.  State survey agencies will then be required to conduct surveys on some weekends based on this list.  If surveyors identify insufficient nurse staffing levels, the facility will be cited for noncompliance and required to implement a plan of correction.

These oversight initiatives are part of broader efforts CMS has underway to strengthen safety and health outcomes for nursing home residents. For example, the Nursing Home Compare website and facility Star Ratings are key resources CMS provides to increase transparency into nursing home quality and help consumers and their caregivers make informed decisions.

CMS also operates the National Partnership to Improve Dementia Care in Nursing Homes, which is helping to reduce the inappropriate prescribing of antipsychotic drugs among nursing home residents, and the recently-launched Civil Money Penalty Reinvestment Program, a three-year initiative to improve residents’ quality of life by equipping nursing home staff, management and stakeholders with practical tools, education, and assistance to enhance care.

Medicaid is the primary source of payment for residents of skilled nursing homes. This action by the Federal government will help nursing home residents, and their families, have more confidence that there will be adequate nurses to provide quality care for the residents of such long term care facilities.

We can help you achieve eligibility for Medicaid benefits to pay for long term care in a skilled nursing facility. If you, or a family member, need the services of a skilled nursing facility, but need Medicaid to pay for that care, please call to schedule an appointment so we can help your family member get Medicaid eligible.

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