Average Staffing Hours Incentive

(1) As of October 5, 2020, each nursing facility is required to submit information on its staffing levels, including information demonstrating the facility’s average hours per patient day (HPPD) to EOHHS, in the manner and format requested by EOHHS via administrative bulletin or other written issuance. (2) As of January 1, 2021, a nursing facility that fails to meet an average of at least 3.58 HPPD in accordance with 101 CMR 206.13(1), is subject to a downward adjustment equal to 2% of the facility’s standard rate for that calendar quarter. As of October 1, 2025, for HPPD calculated based on staffing levels in calendar quarters starting in October 2025, a nursing facility that fails to meet an average of at least 3.58 HPPD in accordance with 101 CMR 206.13(1) is subject to a downward adjustment that will be equal to 0.5% for HPPD between 3.57 and 3.48; 1% for HPPD between 3.47 and 3.38; 1.5% for HPPD between 3.37 and 3.28; and 3% for HPPD at 3.27 or below. The dollar amount resulting from this adjustment will be considered an overpayment pursuant to 130 CMR 450.235: Overpayments. HPPD Average (for calendar quarters beginning October 1, 2025) Downward Adjustment Percentage 3.58 or above 0% 3.57 – 3.48 0.5% 3.47 – 3.38 1% 3.37 – 3.28 1.5% 3.27 or below 3% (3) To determine a facility’s average HPPD in each calendar quarter, EOHHS will divide the facility’s total number of productive hours worked by nursing staff, including registered nurses, licensed practical nurses and nurses’ aides, in the calendar quarter by the facility’s total number of patient days in that calendar quarter. (4) EOHHS may issue administrative bulletins or other written issuance to further clarify these provisions and to provide additional guidance regarding what qualifies as productive hours, what staff types are included in nursing staff, the reporting requirements, and the requirements for disputing the calculation described in 101 CMR 206.13(3).