On January 7, 2022, CMS published QS0–22-08-NH, entitled “Nursing Home Staff Turnover and Weekend Staffing Levels.” This document reflects the changes that CMS will begin positing on the Care Compare website. These changes include:

• Weekend Staffing
• Staff Turnover

Weekend Nursing Staffing

CMS wrote in QSO 19-02-NH that “due to concerns related to low staffing on weekends, in November 2018, CMS began identifying facilities with reported low weekend staffing to state agencies and requiring state agencies to conduct surveys in a portion of those facilities on weekends.”

Also, in August 2020, the OIG recommended that CMS should explore ways to provide consumers with additional information on daily staffing levels and how weekend staffing compares to other nursing homes.  In addition, the OIG noted the need to identify the impact of COVID-19 CMS report measures of nurse turnover as soon as possible in August 2021.

As a result of these recommendations, CMS will begin posting date on the level of weekend RN and total nurse on the Care Compare website in January 2022.  This information will also be added to the Nursing Home Five Star Quality Rating System in July 2022 

Nursing Home Staff Turnover

The relationship between staffing turnover and quality is also being reviewed. CMS plans to post the following measures on staff turnover in January 2022 including:

• The percent of RN staff that left the facility over the last year
• The percent of total nurse staff that have left the facility over the last year
• The number of administrators that have left the facility over the last year.

CMS will include these measures in the Staffing Domain of the Five Star Rating System Technical Users’ Guide on January 14, 2022, This information is being posted for stakeholders to conduct their own analysis. The employee-level data will be posted in the Payroll Based Journal (PBJ). This data will also be posted on the Provider Data Catalogue, in the section for “Nursing Homes including rehab services”

It’s important that you read and understand which data points work in each of the two new categories. Many providers attended training when the PBJ process first started, however, does your present facility staff understand the importance of this data and do you have systems in place to validate the data prior to submission.

For questions or more information please contact Jena Jackson at jena@whcawical.org, Jim Stoa at jstoa@whcawical.org, or Rick Abrams at rick@whcawical.org.