Nursing Facility Staffing Levels and Payroll Data

Title VI, Subtitle B, Part 1, Section 6106 of the Patient Protection and Affordable Care Act: Section 1128I of the Social Security Act, as added
and amended by this Act, is amended by adding at the end the following new subsection: (g) Submission of Staffing Information Based on Payroll
Data in a Uniform Format- Beginning not later than 2 years after the date of the enactment of this subsection... the Secretary shall require a facility
to electronically submit to the Secretary direct care staffing information (including information with respect to agency and contract staff) based on
payroll and other verifiable and auditable data in a uniform format.
Payroll
Data

Insurance Exchange
Type

Yes
If
suspected
difference

Federal Marketplace

State Marketplace

DE

Yes
If
suspected
difference

MO

Yes

Federal Marketplace

NY

State Marketplace

OH

Yes
If
suspected
difference

TX

No

Federal Marketplace

VT

Yes

State Marketplace

VA

Yes

Federal Marketplace

St.
AZ
AR
CA

Partnership
Marketplace

Vermont (D; State Marketplace)

- Payroll data used to collect staffing levels
- 3.0 hprd ratio since 2001 (based on CMS-sponsored
report)
- Standard monthly reports with quarterly audits
- Staffing level average increased to 3.65 hprd
- Consumers given monthly staffing reports
- Implemented compliance and ethics program in 2011

Partnership
Marketplace

Federal Marketplace

Texas (R; Federal Marketplace)

- No payroll data used to collect staffing levels
- .4 hprd ratio (this includes non-licensed nursing care)
- Annual reporting
- Little transparency; reports citing over-reported
staffing levels through OSCAR system
- No new compliance and ethics program

HPRD: Hours per resident day