MDS Alert

Stay on top of what CMS has up its sleeves for nursing homes.

From COVID-19-relevant information reporting and display to staffing numbers, CMS is aiming to boost transparency for residents’ and prospective residents’ families and other curious people.

Find out more about this and other changes coming to Care Compare.

Note These Vaccination Status Changes

Nursing homes have faced devastation in every phase of the COVID-19 pandemic, and, underlining the availability and usefulness of vaccination, the Centers for Medicare & Medicaid Services (CMS) offers a new way to communicate vaccination status information at each facility.

Details: On Feb. 9, CMS announced it would begin posting COVID booster data for both nursing home residents and staff on its Medicare Care Compare site. “The data will show resident and staff booster rates at the facility level and will include national and state averages,” says Catherine Howden, director of CMS News and Media Group, in a CMS release.

If this surprises you, it shouldn’t. CMS reminds that since May 2020 it has required Medicare- and Medicaid-certified nursing facilities to report their COVID-19 data to the Centers for Disease Control and Prevention (CDC)’s National Health Safety Network (NHSN).

“Providing the booster information on the consumer-friendly Care Compare site is one more tool that allows people to have a more comprehensive understanding of the environment they live in or are considering for themselves or a loved one,” CMS says.

You can find the vaccination rates in the Star Ratings section of Care Compare, by selecting “View COVID-19 Vaccination Rates.” The relevant data will be updated every other Thursday, but the display is delayed by a week or so due to the validation and posting process, CMS says.

Find more information on the policy change at https://www.cms.gov/newsroom/news-alert/cms-makes-nursing-home-covid-19-booster-vaccination-data-available-online-increasing-transparency.

Get Comfortable Airing Staffing Number Woes

For the first time ever, Howden notes in another CMS news release, the agency has begun posting information publicly about staff turnover rates and weekend staff levels.

In the release, CMS defines staff turnover as “percent of nursing staff and number of administrators that stopped working at a nursing home over a 12-month period.” The staff who are counted include licensed nurse staff (registered nurses and licensed practical and vocational nurses), as well as nurse aides who provide much of the direct care and work under supervision/direction of licensed staff.

CMS describes weekend staffing as “the level of total nurse and RN staffing on weekends provided by each nursing home over a quarter.”

Some of the information they will post for each facility includes the percent of RN staff who left in the last year, the percent of total nurse staff who left in the last year, and the number of administrators who have left in the last year. Before this change, the information posted on Care Compare wasn’t detailed enough for stakeholders to analyze staff turnover, said David R. Wright, Director of Quality, Safety and Oversight Group at CMS, in the QSO-22-08-NH memorandum.

Context: Long-term care has suffered the largest percentage of losses in employment of any healthcare sector since February 2020, according to a the American Health Care Association/ National Center for Assisted Living (AHCA/NCAL) release summarizing Bureau of Labor Statistics (BLS) data. For perspective: According to the data, hospitals have lost 2 percent of their workforce, compared to a 15 percent loss suffered by nursing homes.

Nursing homes may feel less “alone” in their staffing woes, knowing that the issues are affecting the entire long-term care industry.

AHCA/NCAL says the combination of burnout and inadequate government reimbursement rates for facilities have made it difficult for long-term care facilities to compete for skilled caregivers.

Staff turnover objectively affects the quality of care residents receive (and, presumably, how seamlessly a facility functions as a workplace). Wright said that preliminary, (unadjusted) analysis of available data shows that “lower RN, total nurse, and administrator turnover are associated with higher Five Star Ratings.”

Howden said the change does not require any additional reporting by facilities because CMS is pulling from data facilities have been submitting via the Payroll-Based Journal (PBJ) program since 2016. However, Wright notes that there are four employee identifiers facilities must link to in order to ensure that their turnover measures are accurate, using the following instructions and templates: