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The new facility assessment provisions at 42 CFR § 483.71 outline rules for compliance with the Minimum Staffing Rule. The key points are:

1. Compliance timeline: Facilities have two years from the date of publication of the Minimum Staffing Rule to comply with the 3.48 HPRD (hours per resident day) and 24/7 onsite RN requirements.
2. Specific staffing requirements: Facilities have three years from the date of publication to comply with the more specific 0.55 RN HPRD and 2.45 NA HPRD requirements.

It is essential for facilities to understand these timelines and requirements to ensure compliance with the new regulations.

The Minimum Staffing Rule for long-term care facilities has been finalized by the Centers for Medicare & Medicaid Services (CMS). The rule requires a minimum of 3.48 hours of direct nursing care per resident day, with at least 0.55 hours provided by a registered nurse (RN) and 2.45 hours provided by a certified nursing assistant (CNA). Additionally, facilities must have an RN on site 24/7.

Facilities will have two years to comply with the 3.48 HPRD and 24/7 onsite RN requirements, and three years to comply with the more specific 0.55 RN HPRD and 2.45 NA HPRD requirements.

The rule also requires facilities to submit staffing data electronically through the Payroll-Based Journal (PBJ) system. Facilities that fail to meet the minimum staffing requirements may be subject to enforcement actions, including civil monetary penalties.

The Minimum Staffing Rule aims to improve the quality of care in long-term care facilities and ensure that residents receive adequate attention and support from qualified staff.

The article discusses the proposed federal staffing mandate for nursing homes, which has been met with criticism from industry leaders and stakeholders. The Centers for Medicare & Medicaid Services (CMS) has proposed a minimum staffing requirement of 2.5 hours of direct care per resident per day, but industry experts argue that this is not sufficient to address the current workforce crisis.

LeadingAge, a national association of non-profit aging service providers, submitted comments to CMS expressing concerns about the proposal. The organization's president and CEO, Katie Smith Sloan, stated that the proposal "will fail" due to its lack of consideration for two major issues: the ongoing workforce crisis and the high implementation costs.

LeadingAge also pointed out that the $75 million allocated for workforce development is insufficient and will not be enough to recruit and retain staff. The organization's vice president of public policy, Ruth Eyigor, called the funding "paltry" and a "drop in the bucket."

The Pennsylvania Health Care Association (PHCA) also submitted comments to CMS, sharing its experience with implementing state-specific staffing mandates. PHCA reported that while providers have been able to meet and exceed the state mandate, certain positions are proving difficult to fill, and staff call-offs and no-shows are exacerbating the issue.

Industry leaders argue that the proposed federal staffing mandate will only worsen access issues for older adults and families if implemented without adequate funding and support. They urge CMS to take greater responsibility and provide more resources to address the workforce crisis.

Key points from the article:

• The proposed federal staffing mandate for nursing homes has been met with criticism from industry leaders and stakeholders.
• Industry experts argue that the minimum staffing requirement of 2.5 hours of direct care per resident per day is not sufficient to address the current workforce crisis.
• LeadingAge expressed concerns about the proposal, citing its lack of consideration for two major issues: the ongoing workforce crisis and high implementation costs.
• The $75 million allocated for workforce development is insufficient and will not be enough to recruit and retain staff.
• The Pennsylvania Health Care Association shared its experience with implementing state-specific staffing mandates, highlighting difficulties in filling certain positions and addressing staff call-offs and no-shows.

Overall, the article highlights the concerns and criticisms surrounding the proposed federal staffing mandate for nursing homes, emphasizing the need for more resources and support to address the workforce crisis.

The American Hospital Association (AHA) has sent letters to the Senate and House urging them to support legislation that would prevent the Centers for Medicare & Medicaid Services (CMS) from enforcing its final rule on minimum staffing requirements for long-term care facilities. The AHA argues that the establishment of minimum staffing requirements would stifle innovation in care delivery and possibly cause nursing homes to reduce capacity or shut down altogether, even if they're performing well on quality and safety metrics.

The CMS' rule, finalized in April, requires all nursing homes that receive federal funding through Medicare and Medicaid to deliver 3.48 hours of daily direct care per patient, with specific requirements for the amount of care provided by registered nurses and nurse aides. The AHA claims that this "one-size-fits-all" approach would create more problems than it solves, particularly in rural and underserved communities that may not have the workforce levels to support these requirements.

The nursing home industry has widely criticized the rule, with the American Health Care Association (AHCA) arguing that it sets an "unreasonable standard" that could lead to widespread closures of nursing homes. Labor unions, on the other hand, have praised the rule as a major step towards strengthening the long-term care workforce and ensuring quality care for patients.

The AHA has called on Congress to disapprove the mandate and prohibit CMS from implementing or enforcing it. The organization argues that safely staffing healthcare facilities requires clinical judgment and flexibility, rather than rigid regulatory requirements. With the fate of the rule hanging in the balance, it remains to be seen how lawmakers will respond to the AHA's plea.

The controversy surrounding the minimum staffing requirements highlights the ongoing debate over how best to ensure quality care for patients in long-term care facilities. While proponents of the rule argue that it is necessary to protect patient safety and well-being, opponents claim that it would lead to unintended consequences such as reduced access to care and increased costs.

The Centers for Medicare & Medicaid Services (CMS) has confirmed its intention to finalize a nursing home minimum staffing rule in 2024. The proposal, which was issued on September 1, requires Medicare- and Medicaid-certified nursing homes to provide a minimum of 0.55 hours of care from registered nurses per resident per day and 2.45 hours of care from nurse aides per resident per day. Non-rural nursing homes would have three years to meet these standards, while rural nursing homes would have five years.

The proposal has received over 46,000 comments, which are being used to inform the development of the final rule. However, advocacy groups such as the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and LeadingAge have expressed concerns about the lack of workers and funding to meet the proposed staffing requirements. They argue that the mandate will have a detrimental effect on seniors' access to long-term care.

The CMS proposal has also raised concerns about the potential impact on other parts of the healthcare system, including homecare and hospice providers. LeadingAge noted that if nursing homes are required to meet higher staffing standards, it could lead to a shortage of workers in other settings. The organization is calling for CMS to address systemic issues such as chronic workforce challenges and inadequate funding before implementing any mandates.

Despite these concerns, CMS officials are pushing forward with the proposal, citing the need to improve safety and quality of care in nursing homes. In addition to the staffing rule, CMS also plans to collect data on ownership in 2024 to explore the role of private equity and real estate investment trusts (REITs) in skilled nursing facilities.

CMS has also reported success with its vaccination program, which has led to over 21,000 residents and 6,000 staff being vaccinated against COVID-19. The agency's survey and certification team also took approximately 10,000 enforcement actions across long-term care facilities nationwide in 2023.