New Federal Requirement to Post
the Number of Licensed and Unlicensed Nursing Staff on Duty on Each Shift
DATE: January 29, 2003 DSL-BQA-03-001
TO: Nursing Homes NH 01
FROM: Michael J. Steinhauer, Resident Care Review Section,
Bureau of Quality Assurance
via: Susan Schroeder, Director, Bureau of Quality Assurance
Effective January 1, 2003, sections
42 USC 1395I-3(b)(8) and 1296r(b)(8) (exit DHFS) require federally certified nursing
homes to "post daily for each shift the current number of licensed and
unlicensed nursing staff who are directly responsible for resident care in the
facility." "Licensed and unlicensed nursing staff" include
registered nurses (RNs), licensed practical nurses (LPNs) and certified
nursing assistants (CNAs) who are on duty to care for residents.
The new requirement was created by the Medicare, Medicaid and SCHIP
Benefits and Improvement and Protection Act of 2000 (BIPA). The law also
requires nursing homes, upon request, to make the nursing staff data available
to the public.
Placement: Facilities should post the report in a public area where
residents, visitors, and staff can easily read it.
Format: The Center for Medicare and Medicaid Services (CMS)
recommended a format for the staffing report with its January 9, 2003
announcement of the new requirement. The CMS
announcement letter and recommended format (PDF, 18
for the report are attached.
CMS suggests that the size of the report be at least 8.5 x 14 inches (legal
size paper) and printed in a font size large enough for people to easily read.
Accuracy: CMS recommends that nursing homes post the report very
close to the beginning of each shift to ensure that the posted numbers reflect
the actual staff working that shift.
Enforcement: CMS has instructed state survey agencies to begin
verifying compliance with the requirement to post staff reports effective
January 1, 2003. State survey agencies will cite noncompliance as a deficient
practice under 42 CFR 483.75(b) [F492], Compliance with Federal, State, and
Additional information: For additional information concerning this
new requirement, you may visit the CMS website at http://www.cms.gov/medicaid/bipa
[no longer operable] or you can contact the regional field operations director assigned to your
region. Their names and phone numbers are as follows: [BQA
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