CMS Requires Staff Competencies for Participation
CMS requires staff competencies for participation. This past September, the Centers for Medicare and Medicaid Services (CMS) as part of a new set of regulations is now requiring staff competency for participation. These new regulations are the first major updates for skilled nursing facilities since 1991.
The implementation for these new regulations is supposed to be phased in over the next three years. A notable exception is the language that has been modified regarding staffing levels and staffing competency. Normally competency would be defined based on a combination of credentials and experience. It seems that under these new regulations more is required.
Now “the facility must have sufficient nursing staff with appropriate competencies and skill sets”. The competency level of the staff is now tied to the acuity level of the specific patient population. The new rule provides guidance for staffing levels by virtue of a new assessment tool. Competency is not defined in the final rule, it is the responsibility of the facility to identify the specific competencies and skills necessary to meet the facilities needs and to provide appropriate training and continuing education.
The new rule is alerting providers that they must be knowledgeable about the specific needs of their patients/residents and design their staffing of their facility to best meet these specific needs.
It is wise for facility administration and staff to review their staffing patterns and make sure that the staff on any specific unit has the competencies necessary to provide the appropriate care for those in their charge. Facilities should consider adding competency/skill-set checklists specific to the unit the staff members are working on. Many facilities already have an informal unit orientation, now would be an excellent time to formalize this process. In all cases documentation of the assessment of the staff and the orientation along with the educational component should be in their personnel files for surveyor review.