How many nursing facilities would meet proposed staffing standards? 5 notes

A KFF report found 45 percent of nursing facilities did not meet staffing levels of 3.5 direct care hours per resident day.

The report, published July 14, analyzed data from 14,575 nursing facilities, or 97 percent of all such facilities, and reported on staffing levels in June. Researchers measured staffing levels in direct care hours per resident day, which equals the total number of hours worked by each type of nursing staff divided by the total number of residents. The report wanted to find how many nursing homes were prepared for possible increased staffing levels from Medicare or Medicaid. Researchers found:

Note: HPRD is a relatively simple measure that does not account for type of nursing staff, type of patients or number of non-nursing staff employed by the facility. 

  • Nearly all facilities met a requirement of 2.5 or fewer HPRD; 85 percent met a required 3 HPRD; and only 29 percent met 4 HPRD.
  • Of residents 83 percent lived in a facility with staffing levels of at least 3 HPRD, but half of residents lived in a facility with 3.5 HPRD and only 23 percent in a facility with 4 HPRD or greater.

  • At any staffing level above 2.5 HPRD, more nonprofit or government facilities met the requirements compared to for-profit facilities.

  • Staffing levels varied by state. At the 4 HPRD level, Texas had the fewest number of facilities with that staffing level, at 12 percent, while 100 percent of Alaska's facilities reached 4 HPRD.

"The proposed [staffing] rule is likely to strengthen the HPRD minimum requirement and could potentially include additional nurse staffing requirements," KFF said. "If the proposed rule includes requirements related to the types of nurses facilities must employ (and the hours they must work) or adjusts the number of required nurses based on patient health and frailty, fewer nursing facilities would meet a given requirement than are shown here."

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