A study for the Centers for Medicare and Medicaid Services listed four minimum staffing scenarios for skilled nursing homes. For each scenario, it detailed the percentage of homes that would need to add staff, the cost to do so and potential savings.
Lowest minimum level
At this level of staffing, about 43% of homes would need to add staff* at an estimated annual cost of $1.5 billion. It would save Medicare an estimated $187 million per year.
| Minimum hours per resident day (HPRD) |
Est. minimum savings from |
Predicted delayed/ omitted care |
|---|---|---|
| • 3.3 total nurse staff • 1.15 licensed nurse staff, including 0.45 registered nurse staff |
• 5,800 fewer hospitalizations • 4,500 fewer ED visits • 4,000 more community discharges |
3.3%/0.04% |
Medium minimum level
At this level of staffing, about 55% of homes would need to add staff* at an estimated annual cost of $2.4 billion. It would save Medicare an estimated $318 million per year.
| Minimum hours per resident day (HPRD) |
Est. minimum savings from |
Predicted delayed/ omitted care |
|---|---|---|
| • 3.48 total nurse staff • 1.23 licensed nurse staff, including 0.52 registered nurse staff |
• 10,400 fewer hospitalizations • 7,500 fewer ED visits • 5,800 more community discharges |
2.3%/0.02% |
Higher minimum level
At this level of staffing, about 66% of homes would need to add staff* at an estimated annual cost of $3.6 billion. It would save Medicare an estimated $410 million per year.
| Minimum hours per resident day (HPRD) |
Est. minimum savings from |
Predicted delayed/ omitted care |
|---|---|---|
| • 3.67 total nurse staff • 1.32 licensed nurse staff, including 0.6 registered nurse staff |
• 11,000 fewer hospitalizations • 13,800 fewer ED visits • 10,000 more community discharges |
1.4%/0.01% |
Highest minimum level
At this level of staffing, about 76% of homes would need to add staff* at an estimated annual cost of $5.3 billion. It would save Medicare an estimated $465 million per year.
| Minimum hours per resident day (HPRD) |
Est. minimum savings from |
Predicted delayed/ omitted care |
|---|---|---|
| • 3.88 total nurse staff • 1.43 licensed nurse staff, including 0.8 registered nurse staff |
• 12,100 fewer hospitalizations • 14,800 fewer ED visits • 12,000 more community discharges |
0.6%/0.002% |
* Based on reported staffing levels from the second quarter of 2021.