What information can I get about staffing?
The following types of staff are included in the nursing home staffing information that is collected by CMS:
- Registered Nurse (RN)
- Licensed Practical Nurse (LPN) and Licensed Vocational Nurse (LVN)
- Certified Nursing Assistant (CNA)
- Physicial Therapists (PT)
Each nursing home reports its staffing hours to its state survey agency. These staffing hours are from a two-week period just before the state inspection. Staffing data reported on Nursing Home Compare come from the states.
The staffing hours are reported by the nursing home into a measure that shows the number of staff hours per resident per day. Staffing hours are reported by nursing homes and displayed as the number of staff hours per resident per day.
Staffing hours per resident per day is the total number of hours worked divided by the total number of residents. It doesn't necessarily show the number of nursing staff present at any given time, or reflect the amount of care given to any one resident.
Why is this important?
Federal law requires all nursing homes to provide enough staff to adequately care for residents. However, there is no current federal standard for the best nursing home staffing levels.
The nursing home must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Certain states may have additional staffing requirements. CNAs provide care to nursing home residents twenty four hours per day, seven days a week. The amount of physical therapy service hours depends on the needs of the resident.
Some nursing homes might require more nursing staff due to the conditions of their residents, and other factors such as whether the nursing home has special care units. Refer to the Nursing Home Checklist - Opens in a new window for questions or observations about this measure that can help you evaluate the nursing homes you visit. You should also look at the State Inspection Results, particularly any Quality of Life or Quality of Care deficiencies.
An Important Caution: These staffing numbers are based on information reported by the nursing home. They represent staffing levels for a two-week period prior to the time of the state inspection. CMS checks the data for unusual reporting issues, like obvious data entry error, and asks states to follow up with nursing homes in those cases. However, there is currently no system to fully verify the accuracy of the staffing data that nursing homes report. Because of this limitation and because staffing levels may have changed since the last inspection, you should be cautious when interpreting the data.
Staffing Education and Training Requirements (Note: each state may have its own specific requirements.)
Registered Nurses and Licensed Practical and Vocational Nurses
By law, Registered Nurses (RNs) must assess nursing home residents' needs. RNs and Licensed practical and vocational nurses (LPNs/LVNs) work together to plan care, implement care and treatment, and evaluate residents' outcomes. Nurses must be licensed in the state. RNs have between 2 and 6 years of education. LPNs/LVNs generally have 1 year of training.
Certified Nursing Assistants
Certified nursing assistants (CNAs) work under the direction of a licensed nurse to assist residents with activities of daily living, i.e., eating, grooming, hygiene, dressing, transferring, and toileting. All full time CNAs must have completed a competency evaluation program or nurse assistant training within 4 months of their permanent employment. They must also pursue continuing education each year.
Physical Therapists (PTs) help residents improve their movement and manage their pain. PTs test muscle strength, the amount of flexibility in joints, and the residents’ ability to walk or move. PTs often work with other providers, such as doctors, nurses, and Occupational Therapists (OTs) to create individualized therapy plans to address and restore the resident’s physical function and well-being. All States license PTs.