Nursing homes and other healthcare facilities must now electronically submit to CMS complete and accurate direct care staffing information, including information for agency and contract staff, based on payroll and other verifiable and auditable data in a uniform format specified by CMS. This information must include the category of work for each person on direct care staff, resident census data, and information on direct care staff turnover and tenure, and the hours of care provided by each category of staff per resident per day. The facility must also distinguish between employee and agency and contract staff, and submit the data on a schedule specified by CMS. Failure to submit this data will result in a deficiency citation. Facilities must also use the Sufficient and Competent Staff Critical Element Pathway to investigate any concerns related to sufficient staffing.

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