The Columbus Dispatch reported on how significant and frequent staffing fluctuations affect the quality of care provided to nursing home residents.  Consistency and personal attention lead to better-quality care but that is not provided according to the recent analysis by Kaiser Health News and The New York Times.  There are particularly large shortfalls on weekends, the analysis said.

Of 56 nursing facilities throughout central Ohio, 12 have average staffing levels, 11 are below average, 11 are much-below average, 17 are above average and five are much-above average, the analysis found.  At the local facilities rated much-below average, the number of residents assigned to nurses fluctuated by nearly 11 people on their best-staffed and worst-staffed days. The number of residents assigned to nurse’s aides at these homes fluctuated by about six people.

The analysis proves the staffing problems are worse than thought, following a switch in how nursing facilities report their staffing levels to the federal Centers for Medicare and Medicaid Services.  Until recently, nursing homes self-reported unverified data for two weeks and were then inspected, meaning homes could potentially anticipate an inspection and temporarily bring in more staff and “game the system,” the analysis said.  About 70 percent of the nation’s nursing homes reported lower staffing using the new data-reporting method, with an average decrease of 12 percent, the analysis found.

Now, all nursing facilities must provide daily payroll records to verify their staffing levels, following a mandate from the Affordable Care Act of 2010 that more accurately illustrates how staffing levels vary from day-to-day. Data from 2017 became publicly available earlier this year and is now being factored into facilities’ overall five-star ratings.  However, payroll records include overtime, sick leave, and vacation days therefore even payroll records will inflate the number of staff actually providing care to the residents.

In light of the findings, the Elder Justice Coalition is calling for congressional hearings to address how staffing shortages slipped under the radar. Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, said her group is continuing to lobby for minimum-staffing requirements.

“We suspect insufficient staffing is the root cause of a number of our complaints,” said Erin Pettegrew, Ohio’s acting long-term-care ombudsman.

Insufficient staffing leads to negative outcomes and serious issues. Residents who need help getting to the bathroom, for example, may try to go on their own if nobody comes to help, which could lead to a dangerous fall. Or residents could be asked to use unneeded incontinence products, which could cause pressure sores, infections and unnecessary hospitalizations.


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