After the nursing home industry got caught gaming the system and inflating their staffing numbers, 1,400 nursing homes have lower star ratings in Nursing Home Compare staffing levels.  The decrease in star ratings were mostly caused by inadequate numbers of registered nurses or from a failure to report reliable staffing information.  The Centers for Medicare & Medicaid Services updated the ratings on July 25, leaving 1,387 out of 15,616 facilities (nearly 9%) with the lowest ratings for staffing, per a Kaiser Health News analysis.

Kaiser’s analysis found that for-profit nursing homes had 16% fewer staff than nonprofits. It also found that for-profits had one registered nurse for every 43 residents, compared to one RN to every 28 residents at nonprofit facilities. On weekends on average, there were 11% fewer nurses providing direct care and 8% fewer aides, Kaiser reported. On the best-staffed days, one certified nursing assistant or aide oversaw nine residents on average, but on the worst-staffed days, an aide was responsible for 16 residents.

The biggest surprise in the data related to a lack of registered nurses.  CMS requires only a minimum eight hours a day for registered nurse in every facility. The facilities with a one-star staffing rating had a lack of a registered nurse for a “high number of days” over three months, provided unverifiable information to the government or didn’t supply payroll data in any way, Kaiser reported. Downgraded homes had a week or more without any registered nurses, according to the analysis.

The lower rankings doesn’t mean staffing has declined, said David Gifford, M.D., the American Health Care Association Vice President of Quality & Regulatory Affairs.  “While staffing is one of many important metrics in quality care, what really matters are health outcomes and customer satisfaction,” he said in a statement. “The changes to the CMS Five-Star system doesn’t mean that staffing or quality has actually changed in the past several months.”

Huh?  I guess it was crappy before they caught inflating the numbers for higher star ratings!

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