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Employee Turnover & Weekend Staffing Levels Going Public On Nursing Home Compare

January 12, 2022 | Peter Corless


In a memo issued on Friday, January 7, 2022, The Centers for Medicare & Medicaid Services (CMS) announced that both weekend staffing levels and employee turnover data will be made public on Nursing Home Compare starting this month. This same data will also be utilized in the Nursing Home Five Star Quality Rating System in July 2022.

As the memo states, “Staffing in nursing homes has a substantial impact on the quality of care and outcomes residents experience.” As CMS data has found, lower turnover among RNs, nursing staff and administrators often correlates with higher Five Star Ratings.

CMS-turnover-stars-v3
Source: Centers For Medicare & Medicaid Services (CMS)

In addition, as CMS notes, lower turnover often means higher continuity of care as staff are more familiar with resident conditions and could therefore more readily identify a change in condition sooner. Familiarity with an organization’s policies and procedures also comes into play, often resulting in more effective & efficient delivery of care. “Lastly, facilities with lower administrator turnover may have greater leadership stability, direction, and operations, which may help staff provide care more consistently or effectively to residents,” says CMS.

Based on the impact of turnover on outcomes, CMS believes this information is both important and valuable to potential residents and their families. More specifically, consumers will have access to the following:

  • Percentage of turnover among RN staff over the last year
  • Percentage of turnover of total nurse staff over the last year
  • The number of administrators that have left over the last year

Skilled nursing facilities will need to ensure that their employees in the Payroll-Based Journal system have accurate unique employee identifiers to avoid inadvertently reporting increased turnover.

CMS will also provide greater transparency into weekend level staffing, which for many providers, is often lower than staffing during the weekday. According to the memo, “the Office of Inspector General (OIG) analyzed the level of staffing from day to day and raised concerns that consumers may not be aware that some nursing homes have considerable variation in their daily staffing levels.”

They believe this information would be of value to consumers as they evaluate providers. And in the end, they hope this information will encourage organizations to staff higher on weekends.

You’d be hard pressed to find a provider who disagreed with these points. In an ideal world, staffing would be consistent throughout the week and turnover would remain relatively low. And while the publication of this data has been anticipated, it comes at a time when 96% of providers are facing a staffing shortage, and 47% of skilled nursing providers report they’ve had to limit admissions as a result, according to OnShift’s Workforce 360 survey.

While jobs in senior care are beginning to recover, they are still much lower than pre-pandemic levels, according to the Bureau of Labor Statistics (BLS). Because of this, agency usage is on the rise as providers scramble to ensure they have appropriate coverage to reach the level of care their residents deserve.

The pandemic has created a staffing shortage unlike anything we have seen before, with some organizations seeing turnover rates as high as 200%. The addition of this data on Nursing Home Compare only reinforces the need to better equip your organization with initiatives that can help retain the staff you have and attract the next generation of workers. It’s critical that skilled nursing providers make investments in the employee experience that offers meaningful support and valuable impact.

Technical specifications for weekend staffing and staff turnover measures will be included in the Five Star Rating System Technical Users’ Guide on Jan. 14, and employee-level data will be posted in the PBJ section of data.cms.gov on Jan. 26

For more information, access the full memo from CMS here.

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About Peter Corless

Peter Corless is Executive Vice President of Enterprise Development for OnShift. Peter is a recognized HR leader in post-acute care and is well-known for his achievements at some of the country’s largest post-acute care organizations, including Kindred Healthcare and Genesis HealthCare. As an experienced, chief administrative and human resources officer within these organizations, he developed strategies that reduced turnover, improved recruiting and hiring strategies, and reduced labor costs.

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