New Data Shows Lower Staff Levels at Nursing Homes

A recent report published by Harvard University shows much lower staff levels at nursing homes across the country than previously reported. The author of the study, Fangli Geng, says that a recent change in how nursing homes report their staffing levels shows that up to 70 percent of nursing homes had previously overreported the number of staff between April 2017 and March 2018. The faulty reporting was almost exclusively confined to weekends, especially when counting registered nurses or RNs.

The author of the study point to the more accurate form of reporting currently used by the government. Previously, the number of nurses on staff at a nursing home would be calculated by using the payroll data in the month immediately preceding a health inspection visit. Because nursing home inspections usually occurred around the same time each year, nursing homes apparently increased their staff levels around this time. As part of the Affordable Care Act, nursing homes were required to transmit all payroll data to the federal government – providing a more accurate and complete understanding of nursing staff levels. 

The study, which was reported on by Health Affairs, shines a light on what could be an intentional manipulation of nursing home rankings by facilities across the country. According to the newsmagazine, the number of nurses on staff at a nursing is one of the most important indicators of a facility’s quality. Currently, the federal government does not mandate any minimum number of staffers and only requires one Registered Nurse (RN) be present eight hours each day, or the “equivalent of one shift.” A Licensed Practical Nurse (LPN) must be present at all times.

According to an analysis of the data, Health Affairs reports that nursing homes are having a difficult time satisfying this low standard. The magazine reports that 54 percent of nursing homes met the minimum number of nursing staff less than 20 percent of the time. When it comes to registered nurses, 91 percent of nursing homes met the federal standard – just one registered nurse, working at least one shift a day – less than 60 percent of the time. 

David Stevenson, a professor at Vanderbilt University and one of the study’s co-authors lamented the report’s conclusions to He said, “Staffing in the nursing home is one of the most tangible and important elements to ensure high quality care. Anyone who has ever set foot in a nursing home knows how important it is to have sufficient staffing, something the research literature has affirmed again and again.”

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