Nursing Home Minimum Staffing Standards – Implementation Details to Know

The hotly contested minimum staffing requirement for nursing homes is set to take effect. What does implementation look like for facilities?

On April 22, 2024, CMS affirmed its commitment to hold nursing homes accountable for providing safe staffing levels and high-quality care for its nearly 1.2 million Medicare and Medicaid beneficiary residents. The CMS rule finalizes a total nurse staffing standard of 3.48 hours per resident day (HPRD), which must include at least 0.55 HPRD of registered nurse care and 2.45 HPRD of direct nurse aide care. Facilities may use any combination of nursing staff (RN, LPN/LVN, and nurse aides) to account for the additional 0.48 HPRD staffing standard.

Temporary Exemptions

Some rural facilities and others experiencing staffing hardships may apply for temporary exemptions and a delayed implementation, in recognition of the known issues some facilities are experiencing.

Staggered Implementation Schedule

While to some the nursing home minimum staffing standards don’t seem that difficult, it does represent a challenge for many organizations to recruit enough staff and operationalize their processes to stay compliant.

Phase 1 – Within 90 days of the final rule publication, facilities must meet the facility assessment requirements.

Phase 2 – Within two years of the final rule publication, facilities must meet the 3.48 HPRD total nurse staffing requirement, and the 24/7 RN requirement.

Phase 3 – Within three years of the final rule publication, facilities must meet the 0.55 RN and 2.45 NA HPRD requirements.

The Patient Needs Assessment

The minimum standard requirements are more than about hitting numbers – facilities must use evidence-based methods when care planning and implement those special patient needs into the staffing plan. The staffing plan should not only be tailored to fit the needs of the current patient population, but updated often as those needs change. Learn more about patient needs assessments and evidence-based tools to support staffing decisions.

Is your organization ready to hit these targets? Now is the time to start planning and exploring ways to put the staffing and reporting pieces into place. Votive is an expert in LTC reporting, and is here to help lift the heavy load. Contact us for more information and a free demonstration to learn how we can assist.