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Understaffing in Nursing Homes

09-24-19    

wheelchair in empty hallThe majority of nursing homes (both across Ohio and across the United States) have staffed fewer nurses and caretakers than what they have reported to the government, proving the long-held suspicions that nursing home staffing is incredibly inadequate across the nation.

According to recent federal data, there are frequent and significant fluctuations in day-to-day staffing at nursing homes. On the lowest staffed days at an average facility, each staff member had to care for twice as many patients as s/he would care for on a fully staffed day. However, there are facilities that fall much below this line, leaving staff members to care for many times the number of patients than they are equipped.

This data came from daily payroll records that Medicare recently began gathering and publishing from more than 14,000 nursing homes. Previously, Medicare simply rated each facility’s staffing levels based on each home’s own unverified reports, leading to many homes reporting staffing as being far more adequate than what was reality. These payroll records provide strong evidence that the previous system for rating nursing homes—the five-star rating system—more than often exaggerated staffing levels and rarely identified the daily periods in which inadequate staffing was common.

Nearly 1.4 million people across the United States are cared for in nursing facilities. When nursing homes are short of staff, the nurses and aides are often found scrambling to deliver meals, help residents carry out daily tasks, and answer calls for medication. Essential tasks in a nursing home can be overlooked when the staff is overburdened, which can lead to injuries and hospitalizations that could have been avoided with a proper staff.

In addition to this, in a desperate search for staff in order to meet standards for Medicare’s new reports, homes often find themselves hiring underqualified and undertrained staff. These staff members, untrained and unqualified as nurses and aides, can harm the nursing home patients more than help them. While Medicare does not set a minimum resident-to-staff ratio, it does require the presence of a registered nurse (RN) for eight hours per day, and a licensed nurse (LN) on the home’s property at all times. However, this could lead to one nurse (either RN or LN) becoming responsible for up to dozens of patients at a time.

However, The Centers for Medicare & Medicaid Services said that it is “concerned and taking steps to address fluctuations in staffing levels” that have emerged in new data. Recently, it said that it would lower ratings for homes that have gone more than seven days without a registered nurse in the home and on-the-clock.

In April, the federal government started using these daily payroll reports to calculate average staffing ratings in an attempt to put a stop to nursing homes “gaming the system” and covering when they were understaffed. These new records show that at least one day during the last three months of 2017, a quarter of nursing homes reported no registered nurse at work. Furthermore, out of the 14,000 homes that submitted daily payroll reports, 70 percent had lower staffing than they had reported with the previous method of self-reporting.

With all good things comes a downfall, and this new Medicare system is no different. Medicare still assigns stars (on a five-star system) by comparing homes to each other, rather than to a set scale, which leads to a curved grading system. As a result, a vast number of homes have kept their star rating, despite acknowledging the decrease in staffing levels.

The staff members who work at nursing homes who are not trained nurses—namely, the nursing assistants—earn an average of $13.23 per hour. Nursing homes compete for these workers with each other, and with better paying employers such as hospitals and retailers. This leads to an incredibly high turnover rate for both nursing assistants as well as trained nurses. It seems to be a vicious cycle that never ends: understaffing leads to more responsibility for the remaining staff members, which leads to a high turnover rate, et cetera.

One resident at a nursing home claims that he would roam the halls in search for an aide who was not already bombarded with work, seeking assistance with putting on his shirt. He claims that it is “almost like a ghost town.” Obviously, this is unacceptable and if your loved one needs assistance, they should be able to get it. If you suspect that your loved one is not getting the care they need in a nursing home, the Columbus nursing home abuse attorneys of Rinehardt Law Firm are prepped to help you. Contact us at (419) 529-2020 for a free consultation.

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