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To Advance Information on Quality of Care, CMS Makes Nursing Home Staffing Data Available

As part of its commitment to improve transparency and help families and caregivers find the best quality of nursing home care for their loved ones, the Centers for Medicare & Medicaid Services (CMS) will begin posting for the first time ever, staff turnover rates and weekend staff levels for nursing homes on the Medicare.gov Care Compare website today. Staffing in nursing homes has a substantial impact on the quality of care and outcomes residents experience. Having access to this information helps consumers understand more about each nursing home facility’s staffing environment and choose a facility that provides the highest quality of care that best meets the healthcare needs of their loved one.

Staff turnover is the percent of nursing staff and number of administrators that stopped working at a nursing home over a 12-month period. The nursing staff included in this measure includes licensed nurse staff (i.e. registered nurses (RNs), licensed practical and vocational nurses as well as nurse aides who work under the direction of licensed nurse staff and provide much of the day-to-day care for nursing home residents, such as eating, bathing, grooming and toileting. Weekend staffing is the level of total nurse and RN staffing on weekends provided by each nursing home over a quarter.

CMS has explored the relationship between staff turnover and quality of care and a preliminary analysis indicates that as the average staff turnover decreases, the overall star ratings for facilities increases, suggesting that lower turnover is associated with higher overall quality. Staff turnover data also helps providers to improve the quality of care and services they deliver to residents. This information will allow consumers the ability to review nursing homes’ measures relative to other nursing homes and will also be included in the Nursing Home Five Star Quality Rating System in July 2022.

“CMS has long identified staffing as a vital component of a nursing home’s ability to provide quality care, and CMS has used staffing data to more accurately and effectively gauge its impact on quality of care in nursing homes,” said CMS Administrator Chiquita Brooks-LaSure. “The COVID-19 pandemic has highlighted the importance of staffing for the well-being of residents and it’s more important now than ever that CMS release any information related to staffing that can improve quality. Residents and their families will also find this information valuable as they consider a nursing home for themselves or a loved one.”

Facilities with lower nurse turnover may have more staff that are familiar with each resident’s condition and may be more able to identify a resident’s change in condition sooner. The facility may be able to implement a plan to avoid an adverse event, such as a fall, for a patient. Lower administrator turnover may have a positive impact on leadership stability, direction and operations, which may help staff provide more care consistently and effectively to residents.

For more than ten years, CMS has been posting information on facility staffing measures on the Medicare.gov website, including the average number of hours worked reported for nursing staff per resident per day. These staffing measures are also used to calculate each nursing home’s star rating for the staffing rating domain as part of the Nursing Home Five Star Quality Rating System.

Posting this new information will not create any additional reporting requirements for nursing homes. There is nothing new that nursing homes need to do or report. CMS is using the same data that facilities have been reporting since 2016, as part of the Payroll-Based Journal (PBJ) program. The data is submitted to CMS electronically, and most nursing homes export their data directly from their automated time-keeping or payroll systems.

To review the CMS guidance memo about Nursing home Staff Turnover and Weekend Staffing Levels, please visit: https://www.cms.gov/files/document/qso-22-08-nh.pdf

Centers for Medicare & Medicaid Services, CMS, Nursing Home Staffing

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