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While proposed funding cuts grabbed the spotlight in the administration’s newly offered nursing home pay rule Monday, also within it are some highly noteworthy plans regarding President Joe Biden’s minimum staffing initiative

CMS said it’s specifically seeking input on establishing minimum staffing requirements that nursing homes “will need to meet to ensure all residents are provided safe, high-quality care, and nursing home workers have the support they need.” The administration said on Feb. 28 that it would research and propose federal minimum staffing levels within a year — a goal that Health and Human Services Secretary Xavier Becerra has since said he expects to beat.

On Monday, CMS also said it is asking for stakeholder comment on the implementation of a nursing home staff turnover measure in the SNF value-based purchasing program. 

The measure would detail the percent of total nurse staff that have left the SNF over the last year, and would include a facility’s annual turnover for total nurses and aides.

The measure comes after CMS in late January began posting nursing home staff turnover rates and weekend staffing levels on the site on the Care Compare website. 

“We anticipated that the proposed rule would speak to staffing minimums and other staffing metrics, and it did,” Steven Littlehale, chief innovation officer for Zimmet Healthcare Services Group told McKnight’s Long-Term Care News on Monday. “It was expected. But still, as providers deal with unprecedented staffing shortages, the proposed rule had all qualities of an undesired surprise.” 

“Thankfully” providers are in the comment phase for both required minimum staffing and a staffing turnover metric to be added to SNF VBP, he added. CMS is accepting comments on Monday’s 256-page proposed pay rule until June 10. 

“And, comment we must,” urged Littlehale. “Embrace this moment. We need staffing minimums — and a reimbursement system to afford them. I know it feels like running towards the flame, but instead it’s running towards proper evolution of care delivery and the ability to afford it.”