Just 41% of nursing facilities in Wisconsin currently meet proposed federal staffing requirements, according to a recent Kaiser Family Foundation study.
While the recently released rules from the Centers for Medicare and Medicaid Services won’t take effect immediately, the KFF report shows most states — including Wisconsin — fall well short of the proposed targets.
Under the new requirements, nursing homes getting federal funding through Medicare and Medicaid will need to have 3.48 hours per resident per day of total staffing, including at least 0.55 hours per resident per day for registered nurses and 2.45 hours per resident per day for nurses aides.
In Wisconsin, 131 out of 318 or 41% of facilities meet all three of those requirements, the KFF report shows. While 88% of facilities meet the RN requirement, only 42% meet the requirement for nurse aides and 69% meet the overall requirement.
The rule also requires nursing facilities to have an RN on duty at all times, but the report didn’t include that in the analysis, report authors noted. About 80% of nursing facilities are estimated by CMS to already meet this requirement, the report shows. And eight facilities in Wisconsin didn’t report usable staffing data and weren’t included in the report’s totals.
Since CMS announced the proposed rule in April, the agency has gotten nearly 50,000 comments both in support and against the changes. While leaders of the nursing home industry have slammed them as unrealistic and overly simple, some resident advocacy groups argue the minimum staffing standards are too low and should be increased.
Wisconsin is among the 17 states with between 25% and 49% of nursing facilities meeting the rule’s requirements, while 28 other states fall under 25% on this metric. Three states and the District of Columbia fall between 50% and 75%, and only two states, North Dakota and Alaska, are above 75%.
Only Alaska had all of the nursing homes included in the report already staffed to the minimum standard, though with just 16 reporting facilities its total number is much lower than most other states.
KFF notes most facilities will have several years to meet the new requirements. The requirement for meeting 3.48 overall hours per resident per day takes effect in 2026 for urban facilities and 2027 for rural facilities, while the RN and nurse aide requirements take effect in 2027 for urban sites and 2029 for rural ones.
Also, facilities will be able to apply for temporary exemptions from part or all of the rules if they meet various conditions, and KFF says 25% of all 15,000 nursing homes in the country could qualify according to federal estimates.
CMS will be publishing more information on how nursing home compliance will be assessed ahead of these implementation deadlines.
“Forthcoming decisions about enforcement of the new staffing requirements and the ease with which nursing homes are able to receive hardship exemptions may impact the extent to which the final rule has its desired effect on the quality of care for nursing home residents,” report authors wrote.
See the full report.
