Many nursing homes nationwide are short on staff, leaving residents to unable to see a nurse or caretaker as frequently as they should, according to new federal data analyzed by Kaiser Health News. The records reveal ongoing and insufficient staffing levels, especially during the weekends. A typical facility on its worst-staffed days takes care of twice as many residents as one that is adequately staffed.
The data was compiled from daily payroll records Medicare has since gathered and published from over 14,000 nursing homes, in accordance with the Affordable Care Act of 2010. Medicare previously relied on the nursing homes’ own claims of how many hours a day their staff members worked to develop the star rating system, allowing the facility to misrepresent the numbers. Now, Medicare uses payroll records to show a more accurate representation of staffing levels.
These payroll records indicate that on average, there are less than 11 percent of nurses and fewer than eight percent of aides providing direct care on the weekends. During the weekdays, a nursing home aide is responsible for at least nine to as many as 14 residents in a shift.
There are about 1.4. million people currently residing in nursing homes. However, when nursing homes are understaffed, it causes staff members to simply get burned out from being overworked and overstressed. This can lead to fatigue and poor patient care. Residents are left ignored and unattended for long periods at a time, which can result in bed sores, infections as well as malnutrition and dehydration.
Medicare does require nursing homes have a registered nurse on staff at least eight hours a day, including on the weekends, and a licensed nurse at all times. And yet, there are no requirements for a specific staff-to-resident ratio.
Nursing homes are not required to consider staffing ratios when deciding how many residents they can accommodate. It is actually determined by how many new residents they can accept based on the number of beds available. Having a staffing ratio would require these facilities to have a certain number of staff based on their number of beds. The benefit of this would ensure a nursing home has adequate staffing levels.
Out of the 14,000 nursing homes that submitted payroll records, seven out of 10 facilities had low staffing. On average, this is a 12 percent decrease based on the new federal data. Medicare’s five-star rating system is still a work in progress. Star ratings are still assigned based on a grading curve while other facilities have managed to keep their rating despite payroll records indicating a shortage of staff compared to what was previously reported.
More than 1,000 other nursing homes were also not given a rating by Medicare due to data anomalies or simply being a new facility lacking a staffing history.
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