Impact and Strategies: Navigating the Proposed CMS Staffing Mandate for Your LTC Facility

April 2, 2024 Lauren Kaufmann

The Centers for Medicare & Medicaid Services (CMS) released proposed a staffing mandate in 2023 aimed at improving the quality of care in Long-Term Care (LTC) facilities. While the mandate was created with good intentions, it comes with specific staffing targets that could present opportunities – but also challenges – for LTC organizations and facilities. 

What is the CMS Staffing Mandate? 

The CMS staffing mandate is designed to address concerns about minimum nurse staffing standards, hours per resident per day (HPRD), and RN on-site requirements. Its ultimate intent and goal is to ensure quality of care across all facilities by ensuring they have adequate staffing to meet the needs of residents. 

Challenges and Opportunities for Long-Term Care Facility Management

One of the main challenges posed by the CMS staffing mandate is the need for LTC facilities to adjust their staffing models and practices. This may require additional hiring, training, and restructuring of existing roles. Facilities may also face difficulty attracting new employees because of the LTC industry staffing shortage, as well as financial constraints in meeting the new requirements.

Amidst these challenges lie significant opportunities, though. By investing in appropriate staffing levels and ensuring that team members are well-trained and qualified, LTC facilities can enhance the quality of care provided to residents. Improved staffing can ultimately lead to better health outcomes, increased resident satisfaction, and higher CMS ratings for facilities.

What You Need to Know: Understanding the Mandate for Compliance and Resident Well-Being

In short, this mandate proposal calls for specific minimum staffing ratios per resident per day.

This ultimately breaks down into the following changes: 

  • Minimum Direct Care Hours per Resident per Day (HPRD): At least .55 hours of care from a Registered Nurse (RN) and 2.45 hours of care from a nurse aide (NA) per resident per day. 
  • 24/7 RN On-Site: All LTC facilities must have an RN on-site 24 hours a day, seven days a week.
  • Enhanced Facility Assessments: More frequent and comprehensive assessment of facilities may take place to ensure long-term care staffing management are meeting the new standard and identify potential issues. 

Why are these three key changes being proposed? The reason behind proposing a minimum of HPRD is that a higher level of care will be provided since this ratio exceeds existing standards in most states. The stipulation to have an RN on-site is so that access to critical medical expertise is ensured throughout the day and night. Additionally, more frequent assessments may take place to double-check long-term care staffing management are meeting the new standards (and help identify any potential issues). 

The Future of LTC: Will the Proposed Staffing Mandate Be a Turning Point?

The proposed CMS staffing mandate has long-term care facilities buzzing. With an emphasis on increased nurse staffing levels, this mandate aims to improve resident care. But what does it mean for your facility in practical terms and the future of the long-term care industry? 

Recruitment & Retention: The mandate will most likely result in each facility needing more staff, so organizations and facilities need to be ready to attract and retain top talent. 

  • Competitive Offerings: Attract top talent with competitive salaries, sign-on bonuses, and robust benefit packages.
  • Career Development: Invest in skill development programs to upskill your existing staff and enhance their career prospects within your facility.
  • Staff Resources: Consider all resources available to have the right number of staff on-site, including leveraging agencies.  
  • Consider Applicant Tracking Software: By centralizing candidate data, facilitating efficient resume screening and applicant communication, an ATS helps to boost overall quality of hires and saves time finding quality candidates.

Masterful Scheduling & Optimized Staffing: With the right technology partner, scheduling issues can be mitigated by anticipating gaps or needs before they arise. 

  • Data-Driven Census-Based Scheduling Software: Utilize an automated scheduling solution that pulls in resident data to predict peaks in care needs and creates staffing schedules based on your mandated staff to resident ratios for maximum efficiency.
  • Flexible Scheduling: Implement flexible work arrangements like part-time options or split shifts to meet varied staff needs and attract a broader talent pool.
  • Cross-Training: Cross-train existing staff to maximize their skillsets and ensure coverage during staff shortages.

Employee Engagement: the right technology partner can not only make staffing seamless, but it can also help with team member engagement and retention.   

  • Mobile accessibility: Provide team members with a mobile app that gives them the capability to check their schedules, pay stubs, and more through their phones versus having to rely on being on-site to complete these tasks. 
  • Streamlined communications: The right messaging system means all team members can be notified of shifts available to pick up – and do so right away – to help avoid scheduling gaps. 
  • Empower employees: Through enhanced scheduling software platforms, give employees the ability to swap shifts regardless of where they are (i.e. through mobile apps and accessibility) to help expedite and execute schedule changes. 

By implementing these proactive strategies, LTC facilities can not only meet the CMS staffing mandate but also cultivate a future of exceptional resident care. The road ahead requires innovation, collaboration, and a commitment to resident-centered excellence. Smartlinx is a workforce management powerhouse specifically designed for the long-term care industry and its unique needs.

Let's embrace this opportunity to transform long-term care for the better together. Schedule a demo to find out more so we can help you start preparing for these staffing changes today. 

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