Staffing instability can influence a nursing home's care quality star rating, though it is not one of the measurements used by CMS to calculate the metric, according to a study published Dec. 16 in Health Affairs Scholar.
As part of its newly launched Nursing Home Staffing Campaign, CMS is offering eligible nursing homes an opportunity to apply for funding to recruit and retain registered nurses. The staffing campaign was launched in response to industrywide workforce shortage concerns looming over the agency's impending minimum nursing home staffing rule.
A study led by researchers at University of California Irvine analyzed CMS data from more than 13,600 nursing homes during the third quarter of 2023 to calculate how the inclusion of staffing instability would effect care quality ratings.
Here are three notes from the study:
- CMS uses a Five-Star Staffing Composite score made up of six quality measures that reflect nursing hours per resident day and turnover. Researchers calculated and added a staffing instability score to the CMS composite, according to a Jan. 14 news release from UC Irvine.
Staffing instability is defined as the percentage of days per quarter in which total nurse staffing hours per resident day are 20% or more below the facility's average total nurse staffing hours per resident day. - When staffing instability was added to the score, 21% of nursing home quality star ratings changed in the most conservative model. In a less conservative model, 40% of nursing home quality star ratings changed.
- "Families and prospective residents often rely on these care assessments when choosing a nursing home," the news release said. "The study's authors strongly recommend that staffing instability be incorporated into the Five-Star ratings."
Access the full study here.