Data Shows Marginal Increase in Number of Nursing Homes Hitting Staffing Levels
Based on Payroll-Based Journal (PBJ) data for the third quarter of 2023, 71 percent of the state’s nursing homes were unable to meet at least one of the specified staffing level requirements, a slight improvement of three percentage points over the previous quarter. Nursing homes are required to report auditable, payroll-based daily work hours for all nurses and many other staff members to the Centers for Medicare and Medicaid Services (CMS) that compiles the data. The State uses PBJ reporting as the basis for monitoring compliance with State staffing level requirements.
While rates improved among both groups, the compliance gap based on sponsorship has widened, with 50 percent of non-profit and public homes meeting the requirements and fewer than 20 percent of for-profit homes meeting the costly mandate. Regionally, Long Island and the Rochester area continued posting the highest overall regional compliance rates, which now stand at approximately 40 percent. In NYC and the Capital Region, about 21 percent of homes met all three requirements, while the proportion in Western NY stood at 24 percent. Central NY was at the statewide average of 29 percent.
State legislation requires nursing homes to provide at least 3.5 hours of combined Registered Nurse (RN), Licensed Practical Nurse (LPN), and Aide hours per resident day. Of these, a minimum of 2.2 hours must be provided by Certified Nurse Aides (CNAs) and at least 1.1 hours must be provided by RNs or LPNs. Homes meeting the 3.5 total hours requirement but failing one of the other thresholds (e.g., have well over 1.1 hours of licensed nursing staff, but just miss the 2.2-hour Aide threshold) are out of compliance and face penalties.
Most recently, the Department of Health (DOH) distributed compliance notices to providers covering the second quarter of 2022. Providers had 10 days to submit requests for penalty reductions by providing evidence of efforts to retain and recruit staff despite the continuing staffing crisis. In addition to a previously issued determination for 2022, the Commissioner of Health issued a determination for the first two quarters of 2023 that the state continues to face an acute, statewide shortage of RNs, LPNs, and Aides.
LeadingAge NY has updated a staffing tool that displays daily, facility-specific staffing levels calculated using PBJ data for the third quarter of 2023. The tool calculates daily staffing levels using eligible hours as specified in State law, compares them to the three staffing requirements, and highlights discrepancies. Members can find the download link here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841