Proposed Minimum Nurse Staffing Levels in Nursing Homes

Abt Associates. (2023). Nursing Home Staffing Study Comprehensive report. Report prepared for the Centers for Medicare & Medicaid Services. June 2023. https://edit.cms.gov/files/document/nursing-homestaffing-study-final-report-appendix-june-2023.pdf

Centers for Medicare & Medicaid Services. Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting. (CMS-3442-P). CMS-2023-0144. 88 Fed. Reg. 61352 (Sept 6, 2023). https://www.federalregister.gov/documents/2023/09/06/2023-18781/medicare-and-medicaid-programs-minimum-staffing-standards-for-long-term-care-facilities-and-medicaid

Centers for Medicare & Medicaid Services, Abt Associates Inc (2001). Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. Report to Congress: Phase II Final. Volumes I–III. CMS.

Edelman T. (2019). Nurse staffing deficiencies. Center for Medicare Advocacy, 2019. http://www.medicareadvocacy.org/staffing-deficiencies-in-nursing-facilities-rarely-cited-seldom-sanctioned/

Geng F. Stevenson D. G. Grabowski D. C. (2019). Daily nursing home staffing levels highly variable, often below CMS expectations. Health Affairs, 38(7), 1095–1100. https://doi.org/10.1377/hlthaff.2018.05322

Harrington C. Dellefield M. E. Halifax E. Fleming M. L. Bakerjian D. (2020). Appropriate nurse staffing levels for United States nursing homes. Health Service Insights, 13, 1–14. https://doi.org/10.1177/1178632920934785

Harrington C. Mollot R. Braun R. T. Williams D. Jr . (2023). United States’ nursing home finances: Spending, profitability and capital structure. International Journal of Social Determinants of Health and Health Services, 1–12. https://doi.org/10.1177/27551938231221509

Hawk T. White E. M. Bishnoi C. Schwartz L. B. Baier R. R. Gifford D. R. (2022). Facility characteristics and costs associated with meeting proposed minimum staffing levels in skilled nursing facilities. Journal of the American Geriatrics Society, 70(4), 1198–1207. https://doi.org/10.1111/jgs.17678

Li Y. Harrington C. Temkin-Greener H. , et al. (2015). Deficiencies in care at nursing homes and in racial/ethnic disparities across homes fell, 2006–11. Health Affairs, 34(7), 1139–1146. https://doi.org/10.1377/hlthaff.2015.0094

Office of the Inspector General (2019). Trends in deficiencies at nursing homes show that improvements are needed to ensure the health and safety of residents. HHS Data Brief. April. 09-18-02010.

PHI (2021) Direct Care Workers in The United States https://www.phinational.org/resource/direct-care-workers-in-the-united-states-key-facts-2/

Ruffini K. (2022). Worker earning, service quality and firm profitability: Evidence from nursing homes and minimum wage reforms. Review of Economics and Statistics. 1–46. https://doi.org/10.1162/rest_a_01271

Schnelle J. F. Schroyer L. D. Saraf A. A. Simmons S. F. (2016). Determining nurse aide staffing requirements to provide care based on resident workload: A discrete event simulation model. J. American Medical Directors Association, 17, 970–977. https://doi.org/10.1016/j.jamda.2016.08.006

The National Academies of Sciences, Engineering, and Medicine (NASEM), Board on Health Care Services, Health and Medicine Division, Committee on the Quality of Care in Nursing Homes. The national imperative to improve nursing home quality: Honoring our commitment to residents, families, and staff. The National Academies Press. 2022. https://nap.nationalacademies

White House Fact Sheet: Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes. February 28, 2022. https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/