Previously, the Centers for Medicare & Medicaid services allowed nursing homes to self-report how many registered nurses they had on staff. They would typically only verify these numbers through payroll data submitted in the weeks prior to an inspection. However, the agency recently unveiled a new way of rating nursing homes that has affected some facilities’ ratings, as McKnight’s reports.
The ratings for having registered nurses on staff are now based upon Payroll-Based Journaling, requiring nursing homes to submit payroll information to allow CMS to determine their ratings.
On the CMS Nursing Home Compare website, nearly 1,400 facilities lost a star rating due to the new way of calculating staffing ratings. Most of these staffing ratings were due to findings that facilities did not have a registered nurse working at the facility every day.
CMS requires that every facility has a registered nurse on site for at least eight hours every day.
Downgraded nursing facilities had a week or more during the reporting period in which they had no registered nurses available. Homes that received one star either had a high number of days that there was no registered nurse, provided unreliable information regarding staffing or did not submit any payroll data.
American Health Care Association Vice President of Quality and Regulatory Affairs David Gifford, M.D., was quick to point out that facilities with lower rankings doesn’t mean that staffing has actually declined.
“While staffing is one of many important metrics in quality care, what really matters are health outcomes and customer satisfaction,” he said in a statement.
The reason that CMS began using the Payroll-Based Journaling method of reporting staffing levels was to prevent facilities from “staffing up” around survey times to achieve higher ratings.
Additionally, a Kaiser analysis found that for-profit nursing facilities typically had 16% fewer staff members than non-profit nursing homes.
