CMS finalized the nursing home staffing minimum at 3.48 hours per resident day, with 0.55 RN and 2.45 CNA — are you close? We’re logging 3.32 HPRD this month in a 98-bed building (0.16 short), and leadership is aiming for 3.6 by June, so I’m chasing benchmarks and how you’re counting split shifts.
We’re at 3.54 HPRD in a 120-bed by logging “split shifts” as exact hour blocks from payroll and excluding breaks/meetings — it’s Tetris with time. Concrete step: pull weekly paid productive RN/CNA hours, subtract non-direct time, divide by midnight census; count LPNs toward the 3.48 total but not the 0.55 RN. Are you including agency hours the same way and backing out orientation?
I calculate off average daily census (not licensed beds), export punches by job code, subtract unpaid breaks, and count agency plus any on-unit RN supervisors; “split shifts” get counted minute-for-minute — staffing Sudoku. To nudge 3.32 up, add two 4-hour CNA float blocks around meals/HS and you’ll gain roughly 0.1 HPRD without a full FTE. Are you capturing supervisor time when they take assignments?
Been there until we mapped PBJ job codes and realized we weren’t crediting LPN/LVN direct-care time toward the 3.48 — added about 0.12 HPRD and closed most of a 0.16 gap. Quick step: pull a weekly payroll export and run an RN 0.55/CNA 2.45/LPN remainder check; CMS PBJ basics: https://www.cms.gov/medicare/quality/provider-evaluation-and-prospective-payment/payroll-based-journal. @OP are you counting med‑pass LPN hours or just RN/CNA as you push to 3.6 by June?