Medicare Ratings Updated with Nursing Home Staffing Rates
New federal data suggests that nursing homes have routinely had fewer staff members, including skilled nurses and aides, working with residents than they have let on to family members. The misconstrued data spanned many years, and actual staffing levels at each home were often deficient, particularly on the weekends.
The data was pulled from daily payroll records Medicare gathered and published on more than 14,000 homes – a requirement of the Affordable Care Act of 2010. This information was only recently analyzed by the agency. Prior to this, Medicare rated each facility based on unreliable measures but began to pull more accurate data following an onslaught of poor nursing home media coverage. The payroll records are perhaps the most reliable evidence placed on file in the past ten years.
Approximately 1.4 million people are residents of skilled nursing facilities nationwide and require the competent and attentive care of staff members. However, these employees are often pulled in various directions throughout the work day, tasked with delivering meals, taking residents to the bathroom, answering frequent medication calls, repositioning patients so they don’t suffer from bed sores, and cleaning rooms, among other job requirements. Many of these duties are necessary to avoid client hospitalization, and sometimes, avoidable hospital visits are still reported. It’s typically impossible for them to pause for long periods of times to listen to patients and ensure their needs are being heard without getting distracted by something new requiring more immediate attention.
“It’s almost like a ghost town,” said Jay Vandemark of the weekend shifts at Beechtree Center for Rehabilitation & Nursing Center. Vandemark, 47, suffered a stroke in 2017 and said he frequently has a tough time finding staff members to care for him because they are already swamped with other duties when he requires attention.
“Volatility means there are gaps in care,” said David Stevenson, an associate professor of health policy at Vanderbilt University School of Medicine. “It’s not like the day-to-day life of nursing home residents and their needs vary substantially on a weekend and a weekday. They need to get dressed, to bathe and to eat every single day.” Like anyone else, clients require the same basic daily needs.
Some nursing homes are overly reliant on family visiting hours to tend to tasks that their workers are simply not able to. Loved ones can visit and converse with residents, take them for walks around the facility, and help them dress and comb their hair. This is especially the case on the weekends when data has shown that employee’ duties double and some tasks can get missed.
Nursing home officials say inadequate staffing is a problem because inadequate government funding make it nearly impossible to attract, compensate, and retain good workers. Updating Medicare’s records brings the issues to light and helps to identify the centers with the worst staffing issues. However, it does not force these facilities to up their staffing numbers nor does it improve quality of care across the board. Other, targeted, governmental measures will need to be put into place to address and help regulate the issue.