CMS study finds no single minimum staffing level for nursing facilities

A study commissioned by CMS found no single recommendation for an appropriate level of staffing that would guarantee quality care, KFF Health News reported Aug. 29.

The study, dated June 2023, evaluated four minimum staffing levels, all below the 4.1 level previously identified as ideal. The highest level evaluated was 3.88 daily staffing hours and the lowest 3.3 daily staffing hours. It estimated at the 3.88 level that 0.6 percent of residents would get delayed care and 0.002 percent would not get needed care, compared with 3.3 percent and 0.04 percent, respectively, for the lowest level. The study also estimated that the higher staffing levels would lead to fewer hospitalizations.

A copy of the study was posted to the CMS website but taken down shortly after KFF Health News reported on the findings. Jonathan Blum, CMS’ principal deputy administrator and COO, told the news outlet the study posted was a “draft” and was posted in error. KFF Health News found nothing in the 478-page report that indicated it was preliminary.

“CMS is committed to holding nursing homes accountable for protecting the health and safety of all residents, and adequate staffing is critical to this effort,” Mr. Blum said. “CMS’ proposal is being developed using a rigorous process that draws on a wide range of source information, including extensive input from residents and their families, workers, administrators, experts and other stakeholders. Our focus is on advancing implementable solutions that promote safe, quality care for residents.” 

The study has been widely anticipated, according to KFF Health News, as the last major CMS study was conducted in 2001. However, patient advocates said the report was another sign the Biden administration would fall short on its pledge to establish robust staffing levels in skilled nursing facilities. The administration is six months behind its self-imposed deadline to propose new rules.

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