Significant staffing fluctuations exist at nursing homes across the country, and methods of measuring often mask gross under-staffing. The Recent analysis from Kaiser Health found four significant findings:

1. The analysis found 25 percent of facilities did not report registered nurses at work during October, November and December 2017. Federal officials require “sufficient staffing to meet the needs of the residents”, including a minimum¬†eight hours daily for a registered nurse and a licensed nurse (LPN/LVN) around the clock.¬† However, this minimum time applies to facilities with 44 residents or 220 residents.

2. Seventy percent of nursing homes had lower staffing based on actual payroll as opposed to the self-reported numbers provided by the nursing homes.

3. The average resident-to-nurse ratio on best-staffed weekdays was 18 to 1, compared to 20 to 1 on best-staffed weekends. For worst-staffed weekdays and weekends, those ratios were 30 to 1 and 38 to 1, respectively.

4. There also were fluctuations with aides directly caring for residents on weekends compared to weekdays. On best-staffed weekdays, the resident-to-aide ratio was 9 to 1 compared to 14 to 1 on worst-staffed weekdays. On weekends, those ratios increased to 10 to 1 and 17 to 1, respectively.


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