The Centers for Medicare and Medicaid Services (CMS) recently released the much-anticipated revised guidance for Long-Term Care Facility Assessment regulation (QSO-24-13-NH) to be used as part of the new federal staffing mandate.

To determine compliance, the revisions specify that the facility assessment should:

• Include an evaluation of the resident population and its needs based on evidence-based, data-driven methods.
• Reflect the population.
• Address the facility’s resident capacity.
• Include information on the staffing level(s) needed for specific shifts — such as day, evening, and night — and be adjusted as necessary based on changes to resident population.
• Address what skills and competencies are required by those providing care.
• Be conducted with input from the individuals stated in the regulation (483.71(b)).
• Indicate what resources, including but not limited to, equipment, supplies, services, personnel, health information technology, and physical environment are required to meet all resident needs.
• Include a contingency plan that is informed by the facility assessment.

The guidance states that the facility should have a plan for maximizing recruitment and retention of direct care staff.

The revisions take effect and must be implemented by August 8, 2024. Note that the revised regulatory requirements have been moved from 42 CFR 483.70 to 42 CFR 483.71.