Centers for Medicare & Medicaid Services (CMS) have updated their requirements on minimum health and safety standards that long-term care (LTC) facilities must meet in order to participate in Medicare and Medicaid. The guidance primarily addresses staffing concerns at nursing homes that some say have impacted the quality of care provided.

The CMS have also updated and created new guidance for long-term care facility surveyors, who determine whether facilities meet CMS requirements. The new updated requirements incorporate the use of Payroll Based Journal staffing data, which the CMS have instructed surveyors to use for LTC facility inspections. This system allows for staffing information to be collected on a more frequent basis than it was previously and it is auditable to ensure accuracy. Long term care facilities have access to this system at no cost.

The agency said the data will “help better identify potential noncompliance with CMS’s nurse staffing requirements,” including a lack of a registered nurse for eight hours each day. “This guidance will help to uncover instances of insufficient staffing and yield higher quality care,” CMS also added in their announcement.

The updated guidance also gives additional information on the role of Infection Preventionists (IPs) in LTC facilities. CMS said that IPs are imperative to mitigating the start and spread of infectious diseases, such as COVID-19. Therefore, CMS are requiring that each facility is to have an IP on staff who can oversee infection prevention and control programs.

Staffing has been a large concern in the long-term care sector since the COVID-19 pandemic, whether it be staffing numbers or the regulation of it. Following a study by consulting firm Oliver Wyman, it is estimated that US staffing shortages will cost nursing and rehabilitation facilities as well as home-health agencies $19.5 billion this year.