CMS Staffing Compliance with Facility Assessments

CMS recently released a final rule for the following :

• Minimum staffing standards for RNs and nurse aides

• The final rule contains a provision requiring a state Medicaid agency to report on the percentage of payments for Medicaid covered services that are spent on compensation for direct care workers .

• New requirements to strengthen the Facility Assessment

Let ’ s review each of these new requirements

1 .

Minimum staffing standards for RNs and nurse aides

• CMS is revising section 483.35 ( b ) to require a Registered Nurse ( RN ) to be onsite 24 hours per day 7 days per week ( 24 / 7 RN coverage ) to provide skilled nursing care to all residents in accordance with resident care plans . The previous requirement was for an RN 8 hours per day 7 days per week .

• Facilities must provide , at a minimum , 3.48 total nurse staffing hours per resident day ( HPRD ) of nursing care , with 0.55 RN HPRD and 2.45 nurse aide HPRD . The remaining 0.48 HPRD being any combination of RN / LPN / LVN or nurse aid hours . These standards were developed using case-mix adjusted data sources .

CMS Staffing Compliance with Facility Assessments | Page 2