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The biggest issue for California SNFs is the new 3.5/2.4 staffing ratio.

Mike Smith, VP Advisory Services, StratusLink.


I attended the California Association of Health Facilities (CAHF) Spring Legislative Conference in Sacramento this week. The top issue that fueled much discussion was the upcoming increase in the amount of staffing hours required per patient. Effective July 1, SNFs must have a minimum of 3.5 direct care service hours per patient—and will have a minimum of 2.4 hours per patient day (PPD) for certified nursing assistants (CNAs). With the unemployment rate at around 4%, this makes hiring and training additional CNA staff a serious challenge for SNF operators. CAHF and its members are working to communicate this hardship with legislators, not to repeal, but to request a gradual implementation. CAHF also announced a new website with resources to help manage these and other workforce challenges.


Another important issue discussed during the conference, was the Quality Accountability Supplemental Payment Program (QASP). With significant incentive payments available ($90 M), analyzing and calculating data accurately and timely are keys to success. In fact, an error of just .00001 points could be the difference in qualifying for an award. In my discussions with several CAHF members, they mentioned the complexity of the program and the amount of time and effort involved in the collection and analysis of data for QASP. Typically, the data comes from disparate IT systems and it is difficult to consolidate the data in an appropriate format to submit and there is often a concern about accuracy.


Although StratusLink—our data management and business intelligence platform—can’t resolve California’s reduced pool of available CNA’s or the short lead time to full implementation of the 3.5/2.4 staffing requirement, StratusLink can impact staffing issues by giving SNFs immediate data access and easy to understand analysis and exchange capabilities that will enable them to more effectively respond to workforce issues.


Because StratusLink has the unique ability to integrate clinical, financial and operations data from all IT systems, it will automate the feed of QASP data elements from all systems. StratusLink’s advanced analytics will enable SNFs to view the information in one centralized dashboard and prepare the data for accurate and timely submission.

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