Analysis of Minimum Nurse Staffing Levels

This technical report presents an analysis of the proposed minimum staffing standards for long-term care facilities as issued by the Centers for Medicare and Medicaid Services (CMS) on September 1, 2023. The report outlines the proposed requirements for registered nurses (RNs) and nurse aides (NAs), specifying a minimum of 0.55 hours per resident day (HPRD) for RNs and 2.45 HPRD for NAs, along with a mandate for 24/7 RN coverage. It details the financial implications of these staffing requirements, estimating the annual cost to be approximately $6.8 billion, which necessitates hiring around 102,000 additional full-time equivalents (FTEs). The report also discusses the challenges faced by skilled nursing facilities (SNFs) in meeting these standards, including the potential impact on facility operations and resident care. Furthermore, it highlights the need for evidence-based care planning and facility assessments to ensure compliance with the new staffing mandates.