2023-18781.pdf (federalregister.gov)
- RN on site 24×7
- Minimum: 0.55 RN hours per resident day
- Minimum: 2.45 NA hours per resident day
- Hours per resident day (HPRD) = (total number of hours worked by each type of staff ) / (total number of residents)
- Exemptions:
- workforce is unavailable or the facility is at least 20 miles from another long-term care facility
- facility is making a good faither effort to hire and retain staff
- facility provides documentation of its financial commitment to staffing
- facility has not failed to submit PBJ data, is not a special focus facility, not been cited for insufficient staffing, and has not been cited at the IJ level with respect to staffing in the last 12 months
- Enforcement
- termination of provider agreement
- denial of payment for Medicare/Medicaid residents
- civil monetary penalties