Skinner Robert J, Yu Jiani, Unruh Mark A, Braun Robert Tyler, Jung Hye-Young, Johnson Phyllis, Fernandez Rahul, Stevenson David G
Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN 37203, United States.
Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10065, United States.
Health Aff Sch. 2025 Aug 4;3(8):qxaf154. doi: 10.1093/haschl/qxaf154. eCollection 2025 Aug.
New federal minimum staffing standards aim to increase staffing in nursing homes. As the future of the new rule remains uncertain, this study compares the new standard to existing state staffing standards and examines the characteristics of nursing homes who may meet the new requirement.
We utilized the 2023 CMS Payroll-Based Journal Data to calculate staffing ratios and nurse turnover. We summarized staffing levels by nursing home size, ownership type, chain affiliation, and rurality. We compared state staffing policies using data from the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission (MACPAC). Statistical analyses included Student's -tests and z-tests.
Nursing homes in 11 states had staffing levels below the new federal minimum. Across states, compliance with the new federal requirements ranged from 31% in states with the lowest staffing requirements to 65% in states with the highest. Higher state staffing standards were associated with better quality ratings and lower turnover.
Our paper explores state efforts toward reaching staffing goals. While higher state staffing standards correlate with better nursing home quality ratings, many homes may struggle to meet the new federal requirements.
新的联邦最低人员配备标准旨在增加养老院的人员配备。由于新规定的未来仍不确定，本研究将新标准与现有的州人员配备标准进行比较，并研究可能符合新要求的养老院的特征。
我们利用2023年医疗保险和医疗补助服务中心（CMS）基于工资单的日志数据来计算人员配备比率和护士周转率。我们按养老院规模、所有权类型、连锁关系和农村地区总结了人员配备水平。我们使用来自医疗补助和儿童健康保险计划（CHIP）支付与准入委员会（MACPAC）的数据比较了各州的人员配备政策。统计分析包括学生t检验和z检验。
11个州的养老院人员配备水平低于新的联邦最低标准。在各州中，符合新联邦要求的比例从人员配备要求最低的州的31%到最高的州的65%不等。较高的州人员配备标准与更好的质量评级和更低的周转率相关。
我们的论文探讨了各州为实现人员配备目标所做的努力。虽然较高的州人员配备标准与更好的养老院质量评级相关，但许多养老院可能难以满足新的联邦要求。
