CMS Provides Relief from Nursing Home Staffing Mandate with Flexibility on View Hardship Exemptions and a Phased Implementation Timeline.

The article discusses the final rule issued by the Centers for Medicare & Medicaid Services (CMS) regarding minimum staffing requirements for nursing homes. The rule requires nursing homes to have a registered nurse on duty at all times and sets minimum staffing ratios for certified nursing assistants.

However, CMS has also established exemption criteria for facilities that are facing hardship in meeting these staffing requirements. To be eligible for an exemption, a facility must demonstrate that it is making good faith efforts to hire and retain staff, but is still unable to meet the minimum staffing requirements due to circumstances beyond its control.

The exemptions will be granted on a temporary basis and will need to be renewed at every recertification survey. Facilities that are found non-compliant with the minimum staffing requirements while not meeting the exclusionary criteria will need to provide documentation of their efforts to hire and retain staff, as well as demonstrate a financial commitment to adequate staffing.

CMS officials emphasized that the exemptions are designed to mitigate any challenges in the near term, but ultimately, all facilities must meet the minimum staffing requirements. The agency is also launching a nursing home staffing campaign, with plans to invest over $75 million to support state efforts to allow nursing homes to meet the minimum staffing requirements.

Industry leaders have expressed concerns that the exemptions may not be sufficient and that the financial incentives offered by CMS may not be enough to address the staffing challenges faced by many facilities. However, CMS officials believe that the final rule provides a balanced approach that promotes safe and high-quality care for residents while considering the current challenges faced by some facilities.

Key points:

• The final rule sets minimum staffing requirements for nursing homes, including a registered nurse on duty at all times and minimum staffing ratios for certified nursing assistants.
• Exemptions will be granted to facilities that demonstrate good faith efforts to hire and retain staff, but are still unable to meet the minimum staffing requirements due to circumstances beyond their control.
• The exemptions will be temporary and will need to be renewed at every recertification survey.
• Facilities found non-compliant with the minimum staffing requirements while not meeting the exclusionary criteria will need to provide documentation of their efforts to hire and retain staff, as well as demonstrate a financial commitment to adequate staffing.
• CMS is launching a nursing home staffing campaign, with plans to invest over $75 million to support state efforts to allow nursing homes to meet the minimum staffing requirements.