Only about 20% of nursing facilities currently meet the minimum staffing standards outlined in the final rule.

This article discusses the Centers for Medicare and Medicaid Services' (CMS) final rule on minimum staffing requirements for nursing facilities, which aims to improve the quality of care for residents. Here are the main points:

Key Findings:

• 19% of nursing facilities would meet the minimum Health Personnel-to-Resident Day (HPRD) staffing standards under full implementation of the final rule with their current staffing levels.
• Nearly 60% of facilities would meet the interim requirement of an overall HPRD of 3.48, but fewer facilities would meet the RN and nurse aide provisions that are required when the rule is fully implemented (49% and 30% respectively).

Analysis:‍

• The analysis uses Nursing Home Compare data from March 2024, which includes 14,403 nursing facilities (97% of all facilities, serving 1.18 million or 98% of all residents), and reflects staffing levels from July to September 2023.
• Due to data limitations, this analysis does not look at the 24/7 RN requirement.

Final Rule:‍

• The final rule includes new reporting and assessment requirements and the process by which facilities may qualify for an exemption from the minimum staffing provisions.
• CMS will release additional details later this year on how the $75 million investment in a nursing home staffing campaign will be structured.

Limitations:‍

• The analysis does not evaluate facilities' ability to comply with other requirements in the final rule, including the requirement to always have a registered nurse on duty 24/7 or the ability to meet the new reporting and assessment requirements due to data limitations.
• The analysis also does not estimate which facilities would qualify for an exemption or how staffing levels will change between now and when the staffing standards take effect.

Future Analysis:

• A forthcoming analysis will look at the share of facilities that currently meet the new standards across a variety of dimensions, including ownership, state, and urban or rural location.