CMS Publishes New LTC Guidance, in a Step Closer to Mandatory Staffing Minimums

On June 29, the Centers for Medicare and Medicaid Services (CMS) updated its guidance on requirements for long-term care facilities on staffing levels, arbitration, infection prevention and the administration of certain medications. The agency attributed the guidance to President Joe Biden’s efforts to improve nursing home safety and is expected to soon propose minimum staffing levels for long-term care facilities.

In April, CMS released a request for information as part of the FY 2023 nursing home proposed payment rule that asked for feedback on federal staffing levels, Inside Health Policy reports. CMS says the new guidance will assist tracking the lack of required staff and that payroll data can be used to instigate investigations into insufficient staffing.

The update also includes guidance on Infection Preventionists (IP), who have specialized training to oversee a facility’s infection prevention and control programs. A memo to state survey agency directors on the guidance also says that LTCs are required to retain an IP at least part-time, and that facilities are responsible for an effective infection prevention and control program and should make sure an IP meets their needs, according to the American Hospital Association.

Already grappling with fallout from the COVID-19 pandemic including record-low staffing levels, the long-term care facility industry was less than thrilled with the regulation revisions and the step towards mandatory staffing minimums. Modern Healthcare reports that about 155,000 LTC residents have died from the virus, which is one of the reasons the Biden administration took special notice of the nursing home industry for comprehensive quality and safety changes. From Katie Smith Sloan, president and CEO of LeadingAge, which represents aging services providers:

At this time, when the sector is finding its footing after years of COVID-induced financial stress and workforce challenges, continuing the additional pile-on of regulations will strain already-stretched providers. We all know that staffing goes hand-in-hand with quality care, and our mission-driven members are working valiantly to stay compliant. But we continue to urge the administration to back its words of commitment to ensuring older adults’ access to care with meaningful action and funding.