Many nursing facilities have fewer direct care staff than needed to meet the care needs of their residents, a problem more common in nursing facilities that serve a high share of Medicaid-covered residents. Although the federal government plays an important role in monitoring compliance with its staffing standards, states can also help address staffing challenges in several ways, including increasing Medicaid payment rates, changing Medicaid payment methods, and requiring that facilities meet minimum staffing standards that exceed federal requirements.
This brief provides background information about staffing challenges before the COVID-19 pandemic, summarizes current state policies related to staffing, and discusses prior research about the effectiveness of these policies.
MACPAC also has documented each state’s fee-for-service nursing facility payment policies in State Policies Related to Nursing Facility Staffing.
