Why This Newsletter

For companies who are developing or selling services and medical devices for the US nursing home market the recent federally mandated national nursing home staffing requirements could be of interest.


The Centers for Medicare & Medicaid Services (CMS) issued its final rule outlining nursing homes minimum staffing standards. Staff includes primarily nurses and nursing aids.

This rule establishes, for the first time, national minimum staffing requirements for nursing homes participating in Medicare and Medicaid, the two largest public health plans in the US. Medicare may cover skilled nursing care in a Medicare certified nursing home. It must be medically necessary and does not include custodial care such as assistance with bathing, eating and other daily activities.

Over 1.2 million residents receive care in Medicare- and Medicaid-certified nursing homes. CMS expects non-rural facilities to be following the minimum standard by May 10, 2027, and rural facilities by May 10, 2028.

A summary of the final rule’s designated staffing standards is as follows,

  • Provide residents with a minimum total of 3.48 hours of nursing care per day, which includes at least 0.55 hours of care from a registered nurse per resident per day, and 2.45 hours of care from a nurse aide per resident per day.
  • Have a registered nurse on site 24 hours per day, seven days per week to help mitigate against preventable safety events and deliver critical care to residents at any time.
  • Conduct a stronger annual facility assessment than is currently required to improve the planning and identification of the resources and supports that are needed to care for residents based on their acuity during both day-to-day operations and emergencies. This process will need to include participation from direct care workers and others.
  • Develop a staffing plan to maximize recruitment and retention.


About Rowinski Group

Founded in 2004, Rowinski Group LLC is a reimbursement and healthcare payer data analytics consultancy for medical device, digital health and diagnostics companies who are developing and selling their medical technology in the USA. Rowinski Group has offices in Silicon Valley – San Francisco Bay area and Chicago, Minneapolis, and Raleigh.

Rowinski Group has two core service offerings; securing codes and reimbursement on behalf of companies and applying healthcare payer data analytics to help companies solve business issues such as responding to questions from the FDA and Medicare, sales forecasting, Key Opinion Leader (KOL) identification etc.

Through these service offerings Rowinski Group help U.S. and international companies build their U.S. market share for the medical technology they are developing and selling. For more information visit https://reimbursement.consulting or contact Daniel Zimmerman d.zimmerman@reimbursement.consulting.