PBJ News Category

Minimum Staffing

cms-monitor-nursing-home-performance
Nov 16 2023

β€˜Only the Beginning’: Staffing Mandate Assessments May Push Operators to the Brink

β€˜Only the Beginning’: Staffing Mandate Assessments May Push Operators to the BrinkBeyond minimum staffing requirements, operators may need to prepare for updated assessment requirements, which leaders say will be a β€œcore” aspect of the mandate, along with the 24-hour registered nurse (RN)...
LPN-Exclusion-Confusing
Nov 14 2023

LPN Exclusion Triggers Confusion & Questions

News Digest: Mandated Nursing Minimums Ignores Key Nursing Role CNA's, LPN's and RN's form the backbone of skilled nursing facilities.Β  All three roles are used in calculating and determining a facility's Five Star staffing rating.Β  Yet the proposed rule for minimum staffing completely ignores...
cms-crackdown-staffing
Nov 13 2023

Understanding Staffing Compliance Issues & Exemptions

News Digest:Β Proposed Rule Includes More than Minimum Staffing Lost in the uproar over minimum staffing requirements for RN's and CNA's are a number of additional provisions in CMS' Proposed Minimum Staffing Rule.Β  A delayed rollout and provisions for rural facilities are highlighted by CMS has...
ready-for-pbj-report-submission
Nov 12 2023

How Can Facilities Get Ready for Minimum Staffing Requirements?

News Digest: Resolving Staffing Shortages Is Key to Compliance with Mandate PBJ data and labor force participation data illustrate the challenge for the senior care industry to add staff to the required levels.Β  Various studies and interpretations of minimum rules show that compliance will be an...
comments-minimum-staffing-proposals
Nov 06 2023

Comments on Staffing Rule Pour in to CMS

News Digest: Overwhelming Response to CMS' Proposed Rule on Minimum Staffing The 60 day comment period for the Proposed Minimum Staffing Rule ended November 6, 2023.Β  AHCA and Leading Age associations led efforts to generate industry response.Β  Comments flooded in and extended into a public...
proposed-rule-snf-pps-2023
Nov 04 2023

Plans to Defeat CMS’ Proposed Minimums Rule

News Digest: Various Strategies Floated to Avoid Proposed Minimum Staffing Rule With widespread opposition to CMS' Proposed Rule, a variety of tactics are under consideration to overcome the potential regulations.Β  Both a Congressional over ride and legal challenge to the rule are being openly...
cms-launches-review-nursing-homes-regulation
Nov 02 2023

Congress Weighs in on Proposed Staffing Rule

News Digest:Β Legislative branch questions proposed executive rule Federal legislators in Congress vocally responded to CMS' proposed rule.Β  While CMS considers public comments and works on the Final Rule in 2024, the congressional push back can also provide clues to how Congress may intervene...
changes-to-staffing-measures
Oct 31 2023

Ideas Emerge to Overcome Workforce Shortages

News Digest:Β Minimum Staffing Rules Incent Plan to Hire More Nurses As some view a minimum staffing requirement as almost an inevitability, strategies begin to emerge to accomplish tactics such as increasing the available pool of nursing, lowering turnover of current staff, and improving hiring...
New-Staffing-Measures-Posted-Care-Compare
Oct 25 2023

Supporters of Staffing Mandate Speak Out

News Digest:Β Consumer Advocates, Unions and Some Congressman Support the Staffing Mandate With the loud and consistent negative reaction to CMS' proposed minimum staffing standards, one could fail to recognize that supporters of the new rule exist.Β  Some even believe the minimum standards do not...
nursing-home-staffing-headed-for-scrutiny
Oct 20 2023

Scrutiny on Private Equity & REIT Staffing Performance

News Digest: How does private equity investment affect nursing home staffing and minimum staffing requirementsOnly 6% of real estate investment trust (REIT) assets are in compliance with the federal minimum staffing proposal for nursing homes, compared to the industry average of 19%. This...
minimum-staffing-would-cost-10-billion
Oct 10 2023

Analyses predict high cost of staffing mandate

News Digest:Β Billions needed to comply with minimim staffing mandate Competing estimates of the cost to get all skilled nursing facilities to a minimum staffing level all come in with multi-billion dollar price tags. From CMS' estimate of over $4B to AHCA and CliftonLarsonAllen's $6.8B topped by...
more-than-nursing
Oct 06 2023

Union Impact on Minimum Staffing Rule

News Digest: Unions play a role in the minimum staffing pushHealth and Human Services Secretary Xavier Becerra this week took part in a national union event supporting the proposed nursing home staffing rule, giving the labor audience and their leaders credit for advancing the controversial...
PBJ-Priorities-Avoid-Top-Errors
Sep 30 2023

Strong Early Pushback to Proposed Staffing Rule

News Digest:Β Staffing Shortages and Perceived Benefits Questioned Advocates and the industry absorbed and reacted to CMS' Proposed Rule for Minimum Staffing standards, and quickly shifted into promoting their views.Β  Many questioned the ability to meet a new mandate in light of a widespread...
staffing-mandate-analysis-minimum-nurse-staffing-levels
Sep 30 2023

AHCA & CliftonLarsonAllen Study the Cost of Minimum Staffing Proposals

Analysis from CliftonLarsonAllen compares the potential cost to the long term care industry for meeting (proposed) minimum staffing requirements at three potential levels.

cost-of-pbj-compliance
Sep 20 2023

High costs to comply with potential minimum staffing rule

News Digest:Β High Costs to Comply with Minimum Staffing Rule Before CMS' actual Proposed Rule for minimum staffing was issued in September 2023, researchers, consumer advocates, legislators and industry representatives estimated the potential costs that skilled facilities would incur to comply...
Nursing-Home-Residents-at-Risk-per-study
Sep 01 2023

President Biden Op-Ed Claims Nursing Homes are Putting Residents at Risk

News Digest:Β President Biden Claims Nursing Homes are putting residents at risk With the long anticipated announcement of first-of-their-kind minimum staffing rules, the volume is turned up to 10 across the industry.Β  Knowing the strong pushback and intense lobbying to come, President Biden took...
Nursing-Facility-Prospective-Payment-System-Proposed-Rule
Sep 01 2023

CMS Issues Proposed Minimum Staffing Rule

News Digest:Β CMS Issues Proposed New Minimum Staffing Rule Some predicted that the payroll-based journal program was intended to enable the creation of a minimum staffing requirement.Β  8 years after the PBJ program was launched, that prediction came true when CMS proposed a new rule to establish...
rule-reveals-cms-strategy
Aug 31 2023

Leaked CMS Study Conflicts with Minimum Staffing Plans

News Digest: Leaked CMS Study Conflicts with Minimum Staffing Plans A comprehensive report prepared under contract to CMS by ABT Associates summarizes results from a Nursing Home Staffing Study including reseach activities between May and December of 2022. The report presents options for minimum...
snf-residents-risk-of-displacement
Aug 23 2023

Widening data pool dangerously β€˜chumming the waters’ in nursing home lawsuits

Widening data pool dangerously β€˜chumming the waters’ in nursing home lawsuits A broader public data pool that captures practices of individual nursing homes and patterns across portfolios is being used out of context and further complicating the legal landscape for operators, experts warned as two...
states-also-progressing-towards-staffing-minimums
Aug 03 2023

With federal staffing proposal near, states also progressing toward minimums

News Digest: States also pursuing minimum staffing policies While CMS considers implementing a minimum staffing rule for Medicare (ultimately issued September, 2023), a number of state legislatures have taken up the responsibility to ensure facilities in their state start meeting minimum levels...
cms-developing-minimum-staffing-requirements
Jul 25 2023

AHCA lobbies against potential minimum staffing regulations

News Digest:Β AHCA lobbies against potential minimum staffing regulations There was a long run up between the 2022 announcement of the INTENTION to create minmium staffing regulations until the Sept 1, 2023 announcement of the ACTUAL Proposed Minimum Staffing rule.Β  In that void, associations,...
mursing-home-staffing-study
Jul 14 2023

Only 5 States Meet Nurse Staff Hour Requirements of Potential Minimum Staffing Mandate for Nursing Homes

Only 5 States Meet Nurse Staff Hour Requirements of Potential Minimum Staffing Mandate for Nursing HomesAs many skilled nursing facilities are falling short of expected federal requirements for adequate nursing staff, the shortage has led to a failure to promote the well-being of residents and to...
senate-staffing-cms-policy
Jun 01 2023

Congress weighs in on possible minimum staffing rules

News Digest:Β Congress Weighs in on possible minimum staffing rules CMS took its time between an early 2022 announcement of the INTENTION to create minmium staffing regulations until the Sept 1, 2023 announcement of the ACTUAL Proposed Minimum Staffing ruler.Β  As associations, providers, and...
study-nursing-home-compliance
May 15 2023

CMS Readies Nursing Home Staffing Mandate Proposal, Reviews Study Recommendations

News digest: CMS does not fulfill spring promise to release minimum staffing standardsYet another week came and went without the much-awaited unveiling [of the staffing mandate] announcement. National provider leaders said again this week they have had no indications from federal officials as to...
balance-costs-and-pay-nursing-homes
Apr 23 2023

CMS Official: We’re β€˜Very Seriously’ Weighing Nursing Home Operators’ Staffing Concerns, Creative Solutions Needed

CMS Official: We’re β€˜Very Seriously’ Weighing Nursing Home Operators’ Staffing Concerns, Creative Solutions NeededDr. Shari Ling, Deputy Chief Medical Officer for the Centers for Medicare and Medicaid Services (CMS) on Thursday confirmed that the agency will release a proposed minimum staffing...
proposal-tie-medicare-to-turnover
Apr 18 2023

White House Order Aims to Tie Nursing Home Medicare Payments to Worker Retention

News Digest: Biden order ties medicare rates and turnover ...The roadmap focuses on four priorities: 1) connecting people to good jobs; 2) ensuring we have the skilled, diverse workforce for our transformational investments; 3) boosting education and training efforts so every community can meet...
counterintuitive-to-goal
Apr 14 2023

Minimum staffing requirement: Thank you?

Minimum staffing requirement: Thank you?β€œThe only way to assure there is enough staff in a skilled nursing facility is to implement a minimum staffing requirement.” When you hear or read statements like this from a member of Congress, a staffer at CMS or the White House, or a well-intended...
CMS-take-Active-Role-Ensuring-Adequate-RN-Staffing-Nursing-Facilities
Apr 03 2023

Consumer group counterpunches as nursing homes worry about staffing mandate

Consumer group counterpunches as nursing homes worry about staffing mandateWhile nursing home advocates continue to plead with federal officials about what they call the lack of feasibility for an expected first-ever federal staffing mandate, a notable consumer group has released a report accusing...
cms-rule-comments-minimum-staffing
Mar 20 2023

Completely Out of Touch: Biden’s Minimum Staffing Proposal Comes as Skilled Nursing Reels From Labor Crisis

Completely Out of Touch: Biden’s Minimum Staffing Proposal Comes as Skilled Nursing Reels From Labor CrisisAs state and federal policymakers clamor to set nursing home minimum staffing standards – most recently in the Biden administration’s expansive reform proposals – leaders in the space are...
new-data-highly-variable-staffing-nursing-homes
Mar 13 2023

Advocacy group claims nursing home administrators spent 20 percent less time on-site in recent years

Nursing home administrators spent 20 percent less time on-site in recent years, group claimsAccusations that nursing home administrators are spending 20% less time with residents and on-site miss the mark, said two people who closely observe top facility staff. The claims come from the Long-Term...
oig-finds-shortcomings-in-cms
Feb 17 2023

OIG signals new focus on nursing homes

OIG signals new focus on nursing homesThe federal Office of Inspector General recently publishedΒ  its β€œOIG’sΒ Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs.” In the Top Recommendations, OIG stated that it is aggressively focusing on staffing as a way...
medicaid-funding-key-lever
Feb 15 2023

Study Shows That Higher Spending on Nursing Home Staff is Not Tied to Better Staffing Levels

PBJ research report and related news: This study examined the proportion of facility revenues spent on nursing staff, as well as nursing staff levels in hours worked and paid per resident day, in 2019. Nationally, the median proportion of revenues spent on nursing staff was 33.9 percent, and...
cms-intensifying-nursing-home-oversight
Dec 23 2022

CMS should be careful in what it asks for

CMS should be careful in what it asks for Those in the nursing home sector are worried a potential staffing mandate imposed by the Centers for Medicare & Medicaid Services could be theΒ ruinationΒ of a reeling sector. However, there is an argument to be made that such a move by CMS would be its...
nurse-staffing-at-nursing-homes-lacking
Dec 01 2022

Provider advocates slam β€˜unfair’ media take down of nursing home staffing compliance

A major provider organization Thursday called out a newspaper’s national investigation into nursing home staffing as β€œunfair and mischaracterized.” USA Today’s lengthy article focused on staffing benchmarks set by federal agencies, understaffing of facilities and the harm it causes residents and...
nursing-homes-lack-nurses
Oct 26 2022

The minimum staffing cloud looms. Will any sunlight shine through?

As the leaves start to fall in many parts of the US, so has something else: Hope that a rule establishing minimum staffing levels in nursing homes won’t happen in spring. It’s become abundantly clear over the past few months that the administration will not be deterred from its mission. It will...
alarming-nurse-turnover-rates
Oct 06 2022

3 Nursing Home Legal Issues to Watch in 2022 and Beyond

As a flurry of regulations and mandates descend upon the nursing home sector, such changes could create legal obstacles, and suggest yet another difficult and onerous year for providers. Staffing mandates, the aftermath of the end of the public health emergency (PHE), Covid liability and the PREP...
medicare payment advisory commission medpac logo
Sep 30 2022

MedPAC’s recommendations: state staffing policies could hamper federal mandate

A federal minimum staffing mandate is on the horizon for nursing homes at the beginning of 2023. Providers and experts wonder just how the proposed mandate might address historic staffing shortages without resources or support.

nursing-home-staffing-disadvantaged-neighborhoods
Aug 30 2022

Study: Nursing Home Staffing in Disadvantaged Neighborhoods

Nursing home staffing in severely disadvantaged neighborhoods is significantly lower than staffing in more well-off neighborhoods, according to a new study in which the LTSS Center participated.

cms-desperation-calling
Aug 30 2022

CMS starts study to support minimum staffing proposal

There was a stark, though not at all unexpected, dichotomy between participants in Monday’s listening session to gather input on coming nursing home staff minimums. On the one hand, you had consumer advocates β€” armed with the Biden administration’s aggressive reform push and 20 years of resentment...
comments-on-minimum-staffing-study
Aug 10 2022

CMS reveals differing opinions on minimum staffing approach

A study meant to underpin a new federal nursing home staffing minimum will last about seven months and end in December, a Centers for Medicare & Medicaid Services official said Thursday. That confirmation came during an Open Door Forum conference call Thursday, and amid a fierce, ongoing...
nursing-home-regulations-cost
Jul 28 2022

Nursing Home Staffing Regulations, Proposals Clash With Financial, Operational Realities

Providers in states from Virginia to New York are pushing back on the requirements they say threaten their ability to provide the best care for residents. The Georgia Health Care Association (GHCA) opposes implementing a β€œone size fits all” approach to regulating its providers’ staffing...
state-medicaid-staffing-policy
Jul 05 2022

Why States’ Success in Tying Medicaid to Staffing Could Propel CMS Policy

While establishing stronger staffing standards for nursing homes continues to be a top priority in the minds of federal leaders, few in the industry see it as a viable or sustainable path forward. Unable to sustain unfunded mandates, senior living advocate and policy expert Brian Perry thinks...
staffing-laws-can-improve-nurse-retention
Jun 23 2022

New research shows staffing laws, unionization can improve nurse retention

More than half of the nurses surveyed said they are considering leaving the profession within the next 12 months. Unresolved feelings of moral distress and unsafe staffing were the top reasons cited by nurses considering leaving their roles, according to the study.

Nursing-homes-sue-minimum-staffing-ratios
May 25 2022

Nursing homes sue over minimum staffing ratios, mandatory spending levels

Nonprofit New York nursing homes are taking action against the state in a push to overturn β€œillegal and unconstitutional” policies that establish a minimum staffing requirement and spending mandates for providers. LeadingAge New York, leading a group of 80 nonprofit and public nursing homes, on...
proposed-rule-snf-pps-2023
Apr 30 2022

CMS Releases Skilled Nursing Facility PPS Proposed Rule for FY23

CMS is also seeking feedback on including a Nursing Home Staff Turnover measure in the VBP program. The measure uses data from the CMS payroll-based journal system and reports annual turnover for nurses.

nursing-homes-pay-exorbitant-agency-costs
Apr 24 2022

Nursing Homes Pay β€˜Exorbitant’ Agency Costs to Comply With Staffing Minimums

State staffing minimum laws are colliding with spiking agency costs, with some facilities forced to continue or increase the use of expensive temporary staff to meet state requirements. The dissonance is especially felt in states like New York, which has the largest Medicaid reimbursement...
proposed-state-staffing-standards
Feb 08 2022

Proposed Nursing Home Staffing Standards β€˜Unattainable’ Amid Labor Crisis

Despite continuing nursing home workforce shortages across the country, some states continue to push for mandated minimum staffing hours – Virginia’s legislature was the latest to introduce such proposals, in January.

next-pbj-submission-due
Jan 31 2022

Next Quarterly Payroll-Based Journal Data Submission Due

We remind nursing home members that Payroll-Based Journal (PBJ) data submissions covering Jan. 1st through March 31st must be finalized with the Centers for Medicare and Medicaid Services (CMS) by May 15th. PBJ submissions have been the basis for calculating the staffing domain of the Five-Star...
amda-statement-staffing-standards
Jul 29 2021

Appropriate Staffing Standards in Post-Acute and Long-Term Care

A push to mandate staffing levels at both state and federal levels persists after several decades. Skilled Nursing Facilities (SNFs) and long-term care (LTC) facilities (also referred to as nursing homes or nursing facilities) are no longer just for aging geriatric residents. Acuity level has...
oig-examining-nursing-staffing-levels
Jan 01 2019

A New Focus on Nursing Facility Staffing

The Medicare Requirements of Participation state that a facility must provide sufficient nursing staff on a 24-hour basis and a registered nurse for at least eight consecutive hours per day, seven days a week. With this new topic, OIG will be examining nursing staffing levels that are reported by...

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