A January 2022 memorandum from the Centers for Medicare & Medicaid Services (CMS) titled “Nursing Home Staff Turnover and Weekend Staffing Levels” (Ref: QSO-22-08-NH) has provided compelling new evidence linking staffing patterns to quality of care in nursing facilities.

The CMS analysis revealed a clear correlation between staff retention and facility quality ratings. Specifically, the data showed that nursing homes with higher overall star ratings consistently demonstrated lower turnover rates across all staffing categories. This pattern held true for registered nurses, total nursing staff, and administrators.

This finding adds to previous research examining the impact of staff turnover on patient care. A significant 2021 study, “The effects of high nurses’ turnover on patient care: Perspectives of unit managers in critical care units,” found high nurse turnover contributes to non-compliance with the standard norms of nurse-patient ratios. The study revealed that optimal nurse staffing is essential to delivering high quality, cost-effective care with better patient outcomes.

The CMS data has now quantified these impacts across the nursing home sector. Their analysis indicates that facilities with lower nurse turnover rates may be better positioned to identify changes in resident conditions early and implement timely interventions to prevent adverse events such as falls, acute infections, or preventable hospitalizations.

Weekend staffing emerged as another critical factor. The Office of Inspector General’s analysis revealed concerning variations in daily staffing levels, prompting CMS to implement mandatory reporting of weekend staffing metrics. This new transparency requirement will allow families and regulators to identify facilities that maintain consistently adequate staffing throughout the week.

In response to these findings, CMS now requires nursing homes to report specific metrics including:

• Percentage of RN staff departures over a 12-month period
• Percentage of total nursing staff departures over a 12-month period
• Number of administrator departures within a year
• Weekend staffing levels for both RNs and total nursing staff

The correlation between staffing stability and quality ratings is particularly striking in the CMS data. Their analysis shows that facilities with one-star overall ratings had RN turnover rates approaching 50%, while five-star facilities maintained significantly lower turnover rates. Similar patterns were observed for total nursing staff and administrator turnover.

For families evaluating nursing home options, this newly published data provides crucial insights into facility operations. When reviewing potential facilities, families should examine both weekend staffing levels and staff turnover rates as key indicators of a facility’s capacity to deliver consistent, high-quality care.

Healthcare providers and facility operators should adopt policies and procedures to maintain consistent staffing levels throughout the week. Implementing effective staff retention strategies may be essential steps toward improving patient care quality and outcomes.

This article is intended for informational purposes only and does not constitute legal advice.