Nursing Facility Staffing Requirements Analysis

This text appears to be a report from the Kaiser Family Foundation (KFF) analyzing the impact of proposed staffing requirements for nursing facilities in the United States. The main points are:

1. One in five nursing facilities would currently meet proposed requirements: According to the analysis, about 20% of nursing facilities would already meet the proposed requirements for nurse staffing hours.
2. Adequate funding is a concern: The report notes that adequate funding for nursing facility inspections and enforcement is uncertain, which may affect the implementation of the new staffing requirements.
3. Enforcement of RN requirement is unclear: There are questions about how CMS will enforce the 24/7 RN requirement, as current data only shows total RN hours per day, not when those hours occur.
4. Costs and financing are concerns: The report estimates that complying with the proposed rule would cost $40 billion over 10 years, which may be passed on to payers, including residents and their families.
5. Comparison to proposed rule is uncertain: Changes made to the staffing requirements in response to stakeholder comments could affect how many facilities can comply.

The analysis uses data from Nursing Home Compare as of August 2023, which provides information on quality of care and characteristics for approximately 14,900 Medicare and/or Medicaid-certified nursing facilities. However, there are limitations to the data, including:

• Urban and rural facilities have different timelines: The analysis does not take into account that urban and rural facilities have different timelines to come into compliance with the rule.
• No data on 24/7 RN requirement: Due to limitations of publicly available data, the analysis does not examine facilities that meet the requirement to have an RN on staff 24 hours a day, seven days a week.

Overall, the report highlights concerns about the feasibility and financing of implementing new staffing requirements for nursing facilities.