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  • Writer's pictureMichelle Shank

The Burden CMS is Placing on LTC's

Updated: Apr 2



CMS is proposing a sweeping change to the operations of long term care facilities. How will these proposed changes impact our industry? These changes may look good on paper but do not necessarily address existing staff issues LTC’s are facing.


Staffing Crisis

How plausible is it to find RN’s to staff a facility 24/7 when we are in a crisis for staffing? The new hours requirements for long-term care facilities will have a significant impact in our area.


The most significant impact will be the need to hire additional staff, particularly registered nurses. RNs are in high demand, and it will be difficult for LTCFs to find enough qualified staff to meet the new requirements.

Our industry is already plagued with staffing shortages and a requirement to increase staffing can have a negative impact on the quality of care provided to residents.


Not Accounting for Inflation or Staffing Crisis

The new requirements will also increase the cost of operating an LTCF. This is because LTCFs will need to pay for the additional staff, as well as the cost of any necessary training. This could lead to:

  1. Higher costs for residents

  2. Force LTCFs to cut back on other services.

CMS is willing to raise the requirement but not consider a raise in reimbursing for services, leading the problem of generating more revenue up to the LTCs.


Overall, the new hours requirements for LTCFs will have a significant impact on these facilities and the elderly population.


Other Requirements

  • An RN must be on-site for 8 hours per day, 7 days per week.

  • An LPN or RN on duty 24 hours per day.

  • A licensed social worker must be on-site for 4 hours per day, 5 days per week.

  • A dietitian must be on-site for 2 hours per day, 5 days per week.

  • A physical therapist must be on-site for 2 hours per day, 5 days per week.

  • An occupational therapist must be on-site for 2 hours per day, 5 days per week.

  • A speech-language pathologist must be on-site for 2 hours per day, 5 days per week.

  • A pharmacist must be on-site for 2 hours per day, 5 days per week.

Industry Burdens

These requirements are designed to ensure that residents of LTC facilities receive the highest quality of care possible. However, they leave the Long Term Care Facilities with the burden of figuring out how to meet these requirements without financial assistance. Essentially, they are increasing their operating budget without help with increasing their revenue to help compensate for the requirements.


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