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December 2005
Long-Term Care Nursing Facility Posting of Nurse Staffing Information
On October 28, 2005, the Centers for Medicare and Medicaid Services (CMS)
finalized the requirements that establish new data collection, posting and
recordkeeping requirements for Skilled Nursing Facilities (SNFs) and Nursing
Facilities (NFs). This final rule is also part of a communication outreach
initiative by CMS to provide beneficiaries, their families and the public with
access to updated data and other information to assist them in
making health care decisions. The final rule was effective on December 27, 2005.
The final rule requires SNFs and NFs to post for each shift, on a daily basis, the actual hours and total number of hours worked by licensed and unlicensed nursing staff that are directly responsible for resident care on each shift in the facility. In addition, SNFs and NFs must post the resident facility census and update the data as needed.
CMS defined “licensed nursing staff” as registered nurses. Licensed practical nurses or licensed vocational nurses and “unlicensed nursing staff” are defined as certified nurse aides, as defined under state law.
CMS requires the data be displayed in a clear and readable manner and posted in a prominent place easily accessible to residents and visitors. Each day, at the beginning of the shift, NFs and SNFs must post the following data:
- facility name;
- current date;
- resident census;
- facility–specific shifts for the 24-hour period;
- categories of nursing staff employed or contracted by the facility
per shift - actual time worked for the specified categories of nursing staff, including split shifts;
- number of nursing staff working per shift.
CMS has provided a Daily Nurse Staffing form available on their web site. The facility may choose to utilize this form to enter the information specified above. CMS also allows facilities the flexibility to develop their own documents for displaying the required information. The “document” may be a form or a spreadsheet, as long as all required information is displayed. The information on the document should be located in a clear, visible place, displayed in a uniform manner and presented in a clear and readable format.
The facility must, upon oral or written request, make nurse staffing data available to families and the public for review at a cost not to exceed the community standard. While CMS is requiring the uniformity in the displaying of the nurse-staffing level data for each shift, they are also providing facilities with the flexibility to identify the shift breakdowns so the 24-hour staffing coverage can be determined in an accurate manner. The facility must maintain the posted daily nurse staffing data for a minimum of 18 months, or as required by state law, whichever is greater.
To obtain a copy of the finalized rule on Posting of Nurse Staff Information,
go to www.BriggsCorp.com.
Karen Merk, RN, BS, CRNAC
Clinical Consultant, Briggs Corporation
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