Bloomberg Law
Free Newsletter Sign Up
Bloomberg Law
Free Newsletter Sign Up

Medicare Urged to Improve Oversight of Nursing Home Staffing

Aug. 6, 2020, 9:35 PM

The Medicare agency should improve its oversight of nursing homes’ compliance with daily staffing requirements, a government watchdog agency said after it found hundreds of facilities didn’t meet mandatory levels of manpower for several weeks in 2018.

“This raises concerns that some nursing homes may not have fully met their residents’ needs in 2018,” the Health and Human Services Office of Inspector General said in a report released Thursday.

While the study began before the Covid-19 outbreak, the “pandemic reinforces the importance of adequate staffing for nursing homes, as inadequate staffing can make it more difficult for nursing homes to respond to infectious disease outbreaks like COVID-19,” the report said.

The analysis of nearly 13,000 facilities found that roughly 7%, or 943 nursing homes, reported 30 or more days in which staffing levels didn’t meet at least one required standard. Another 900 facilities—about 7%—failed to meet a staffing requirement on 16 to 29 days, the study found.

And the facilities’ self-reported staffing levels often did not match their staffing ratings scores that are published on the Nursing Home Compare website of the Centers for Medicare & Medicaid Services. In 2018, the CMS began downgrading nursing homes’ staffing ratings for having at least seven days within a three-month period when scheduling of registered nurses did not meet mandatory requirements.

Once the CMS policy was implemented, nursing homes reported 27% fewer days with no registered nurse scheduled. The facilities also reported 7% more days with “some RN time, although less than the required 8 hours per day,” the report said. “These trends suggest overall improvements in staffing levels.”

In response to the OIG’s recommendation to step up oversight of nursing home staffing, the CMS said it will “enhance efforts accordingly.” The agency also said it would explore ways to provide more information about staffing levels to consumers in “clear, consumer-friendly ways.”

To contact the reporter on this story: Tony Pugh in Washington at

To contact the editors responsible for this story: Fawn Johnson at; Brent Bierman at