Medicare Lowers Ratings for Short-Staffed Nursing Homes

In response to insufficient medical and nursing staff, Medicare has lowered ratings for 1 out of every 11 nursing homes across the country. The lowered ratings come after the government agency retooled the way it calculates the nursing staff at each nursing home. Under the new method, which requires nursing homes to submit payroll information every quarter, nursing staff numbers appeared grossly deficient at facilities across the country. After Medicare warned nursing homes in April about a possible reduction in their rating without an increase in nursing staff, the government agency followed through last week and reduced the star-rating for nearly 1,400 nursing homes across the country.

For the most part, the nursing homes with recently reduced ratings lacked a sufficient number of registered nurses, which are the “highest-trained caregivers” and responsible for managing other nurses. Under Medicare guidelines, a nursing home only needs to have a single registered nurse working eight hours per day. However, most nursing homes are not meeting these simple guidelines or could not provide payroll information proving the requirement was satisfied. According to Medicare officials, payroll information is not usually “taken seriously” by nursing homes and forcing the facilities to provide proof through their payroll system will hopefully force nursing homes to take their record keeping more seriously.

Speaking to Becker Hospital Review, David Grabowski, a professor of healthcare policy at Harvard Medical School said that Medicare’s shift is “a real positive that they actually are taking the payroll-based system seriously, that they’re using it to punish hose nursing homes that either aren’t reporting staffing or those that are below the federal limit.”

Some representatives of the nursing home industry do not believe the reduction in their quality ratings is warranted. Katie Smith Sloan, president of LeadingAge, an “aging services provider” group, told Becker Hospital Review that a shortage in nurses is the primary cause of the staffing issue, stating “Our members are battling on multiple fronts to recruit and retain all types of qualified staff, and nurses in particular.”

Medicare, for its part, states that all nursing homes were warned several months ago about the impending reduction in their “star rating.” If the nursing homes that become compliant with the regulations then their rating will be reassessed.

Contact the Law Offices of Thomas L. Gallivan, PLLC.

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