Standard Tier Module
Nursing Home Staffing HPPD Compliance Calculator
A deterministic, in-browser tool for skilled-nursing / long-term-care administrators, Directors of Nursing, and elder-care compliance staff.
See it run - a worked example, 100% in this browser tab
What it is
A deterministic, in-browser tool for skilled-nursing / long-term-care administrators, Directors of Nursing, and elder-care compliance staff. Computes Hours-Per-Patient-Day (HPPD = daily nursing hours / resident census) for RN, LPN/LVN, and CNA/nurse-aide roles plus the total nurse HPPD, and tests each against the CMS Minimum Staffing final rule (2024) floors - total 3.48 HPPD, RN 0.55 HPPD, nurse-aide 2.45 HPPD (42 CFR 483.35 / 89 FR 40876) - AND any state minimum you enter, reporting the STRICTER-OF federal vs. state as the operative requirement with the exact HPPD and daily-hours gap to close any shortfall. No API, no key, no network, no AI - every figure is exact arithmetic over a cited regulatory floor. The federal floors and any state floor are DATED inputs you confirm; a wrong rule version or state never silently mis-tests because the floors actually used are always shown. The federal rule phases in with staggered effective dates and exemptions, which are flagged not auto-applied. Not legal, regulatory, or clinical advice.
Honest scope
Deterministic and citation-backed: every figure is exact arithmetic or a cited rule. Any year- or jurisdiction-indexed value is a confirmable input, never an eternal hardcode. This is a computation tool, not professional (legal, tax, medical, or financial) advice - confirm against the controlling authority for your context.
Authorities cited
- 42 CFR 483.35 - Nursing services: staffing requirements for long-term-care facilities (the regulatory home of the minimum nurse-staffing standard).
- CMS "Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting" final rule, 89 FR 40876 (May 10, 2024) - establishes the 3.48 total nurse-staffing HPPD floor with embedded 0.55 RN and 2.45 nurse-aide HPPD minimums and an RN-onsite 24/7 requirement.
- CMS 89 FR 40876 - phase-in: the total/aide and RN-coverage requirements take effect on staggered dates with separate, later compliance dates for rural facilities; hardship and good-faith-effort exemptions are available (confirm the date and exemption status applicable to your facility).
- Social Security Act 1819(b)(4)(C) & 1919(b)(4)(C) (42 USC 1395i-3 / 1396r) - the Medicare/Medicaid nurse-staffing sufficiency requirement that 42 CFR 483.35 implements.
- CMS Payroll-Based Journal (PBJ) - the staffing-hours data source from which HPPD (total nurse hours worked / resident census per day) is computed for the Five-Star staffing rating and this calculation.
- CMS State Operations Manual, Appendix PP - Guidance to Surveyors for Long-Term Care Facilities (F-tags for 483.35 sufficient-staffing deficiencies).
Run it on your own data
Open it inside GDBS to save runs to Sandbox, attach results to a Worklog case, or share through a Gate client portal - all in the browser, nothing uploaded to anyone’s cloud.