Site Visits Included in CMS Staffing Study

Regulation | August 10, 2022 | by Jodi Eyigor

CMS contractor Abt Associates will be conducting site visits at select nursing homes between August and October 2022 as part of the CMS nursing home staffing study.

Centers for Medicare and Medicaid Services (CMS) contractor Abt Associates has begun reaching out to select nursing homes for participation in site visits as part of the CMS nursing home staffing study. The staffing study is part of the White House plan for nursing home reform and will help inform the development of minimum nursing home staffing standards through feedback from staff, residents, and families on staffing challenges and perspectives on a federal minimum staffing requirement.

Site visits will take place in 65 nursing homes across all 10 CMS regions between August and October 2022. Abt Associates has identified nursing homes for participation based on several factors: location, size, ownership type, staffing level based on the staffing domain of the Five Star Quality Rating System, quality based on the Quality Measures domain of the Five Star Quality Rating System, use of agency staff, and proportion of Medicaid residents served and/or location in a disadvantaged area. Nursing homes declining to participate in site visits will not be penalized and will be replaced in the study sample to ensure ample data can be collected from a representative sample of nursing homes across the country.

Selected nursing homes began receiving contact this week to introduce the study and site visit. Nursing homes will receive a follow up phone call from Abt Associates to schedule the week during which the 2-day site visit will occur. Abt Associates will schedule visits to ensure the Administrator and Director of Nursing (DON) are available and will make every effort to avoid scheduling site visits when state survey agencies might be on site for annual recertification surveys.

During the 2-day site visit, Abt Associates will tour the nursing home and meet with the Administrator and DON. They will work with the Administrator and DON to additionally identify 3-4 registered nurses (RNs), 3-4 licensed nurses (LPNs), and 3-4 nurse aides (CNAs) for interviews. Abt Associates will attempt to interview staff across shifts (primarily day and evening shifts), and will be mindful of not interviewing staff during shift changes or meal times. They will also meet with 2-3 residents and/or families based on who is available in the building during the site visit.

In addition to the site visits, the nursing home staffing study will include a literature review, a quantitative analysis of the relationship between staffing and quality, an examination of costs associated with a minimum staffing requirement, and stakeholder input including feedback received from the Request for Information in the Fiscal Year 2023 Skilled Nursing Facility Prospective Payment System proposed rule. LeadingAge has contributed feedback on both minimum standards and the staffing study and will continue to participate in stakeholder opportunities for input.