The estimate is from a new analysis from KFF published Sept. 18, about two weeks after CMS issued its proposed rule, which includes, for the first time, national minimum nurse staffing standards for nursing homes. The CMS proposal would require nursing homes that receive Medicare and Medicaid funding to provide residents with a minimum of 0.55 hours of care from a registered nurse per resident per day, and 2.45 hours of care from a nurse aide per resident per day, CMS said. The agency proposes that implementation of the final requirements will occur in three phases over three years for non-rural facilities. The proposal does not include requirements for licensed practical nurses.
For its analysis, KFF examined Nursing Home Compare data as of August, with a total analytic sample of 14,591 facilities. The analysis reflects compliance rates if the nursing staff hours requirements were in effect now for all facilities. It does not look at facilities’ abilities to meet other requirements in the proposed rule, such as the phase 2 requirement to have a registered nurse on staff 24 hours a day, seven days a week.
Overall, KFF found that 19 percent of nursing facilities would currently meet the minimum RN and nurse aide nursing staff hours requirements; 90 percent of for-profit facilities would need to hire additional nursing staff to comply; 60 percent of nonprofit and government facilities would need to hire additional nursing staff to comply; and the percentage of nursing facilities that would meet the requirements in CMS’ proposal varies from 100 percent in Alaska to nearly none in Louisiana (1 percent).
“CMS is seeking comment on several alternatives to the proposed rule, one of which would require facilities to comply with requirements that were adjusted to reflect the health and frailty of nursing facility residents,” the KFF analysis states. “Assuming this alternative was implemented using CMS’ existing approach for adjusting staff hours for resident health and frailty, virtually all facilities would need to hire new staff to meet the requirements.”
Read more about the analysis here.
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