Nursing Homes Haven’t Been Forthcoming About Staffing Levels

by Terry Bryant

Medicare data recently analyzed by Kaiser Health News confirms what many have suspected about the quality of care found in most nursing homes in the U.S. It seems that – for a very long time now – there have been fewer nurses and caretaking staff than facilities have reported.

The records also disclose frequent and considerable variations in day-to-day staffing numbers, especially on weekends. At an average facility, on Saturdays and Sundays, on-duty personnel cared for nearly twice as many residents as they did on weekdays when rosters were fuller.

The data comes from daily payroll records which Medicare only recently began compiling and releasing, as required by the Affordable Care Act of 2010 (“Obamacare”). They involve more than 14,000 U.S. nursing homes.

As a result of this new information, Medicare now relies on new data to evaluate staffing. But even these revamped star ratings still do not reveal the inconsistent levels of people working from day to day.

Approximately 1.4 million people receive care in nursing facilities in the U.S. When these facilities are understaffed, workers are hard-pressed to deliver meals, move residents to the bathroom, reposition patients to avoid bedsores, and respond to requests for medication. The result can be avoidable hospitalizations for some elderly patients.

Nursing Homes Haven't Been Forthcoming About Staffing Levels

Areas with depressed nursing home staffing levels. Notice the large collection of red facilities in Texas, especially its larger cities. Map published by Kaiser Health News via the New York Times

This should concern all Texans. The quality of our senior healthcare centers consistently ranks well below average compared to other states; and 25% of the state’s 1,200 long-term care centers have been cited for serious standard deficiencies in the past five years, many repeatedly.

The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees nursing home inspections, said in a statement that it “is concerned and taking steps to address fluctuations in staffing levels” that have emerged from the new data. Hopefully, such serious remedies will help improve Texas’ obscenely low (bottom five) cumulative nursing home ratings in CMS’ annual ranking of quality elder care facilities among all 50 states.

But new rating methods using daily payroll reports to calculate average staffing ratings – as opposed to the old method of less periodic formulae – still reveal staffing shortcomings. Of the more than 14,000 nursing homes submitting these daily payroll records, 7 in 10 had even lower staffing numbers when using the new method, which still reveals a 12% average decrease in workers to take care of your elderly loved ones. Most attrition involves less-skilled workers, the ones charged with daily care and feeding of nursing home patients.

The problem is clear to experts: employee burnout. “They get burned out and they quit,” said one elderly patient’s son, whose mother lived in a nursing home until her recent death. “It’s been constant turmoil, and it never ends,” he added.

If you have a family member in a nursing home or extended care center and suspect abuse or neglect of your loved one, the nursing home abuse attorneys with Terry Bryant Accident & Injury Law are available to answer your questions and offer counsel.