Have regulatory changes at the federal level, while not specifically directed at the goal of increasing nurse staffing, actually led, or may potentially lead, to improved staffing levels at nursing facilities?
On October 4, 2016, the Centers for Medicare & Medicaid Services (CMS) published revised Requirements of Participation (RoP) for skilled nursing facilities (Medicare) and nursing facilities (Medicaid).
Mandating specific levels of direct care nursing staff would seem to be a straightforward method to improve staffing in nursing facilities. If more nursing staff are needed, why not simply require facilities to employ more nurses? The strategy is far more complex, however, than it at first appears. This paper reviews which states have tried this approach, what they have done, how they did it, and whether it worked. It also considers unintended consequences of mandating staffing levels and co
Providing composite scores is intended to help consumers make sense of the large amounts of material on Nursing Home Compare, but composite scores do a disservice to the public when nursing facilities’ self-reported information boosts facilities’ ratings into higher levels.
Residents’ advocates had hoped that the Centers for Medicare & Medicaid Services (CMS) would use the opportunity of comprehensively revising the RoPs, for the first time in more than 25 years, to correct the most serious problem in nursing home standards of care – the absence of a requirement for sufficient numbers of well-trained, well-supervised nursing staff, including the need for registered nurses around the clock. CMS did not.
The single factor most critical to high quality of care and quality of life for nursing home residents is the staff who provide residents with care.
A December 2015 Health Affairs study of freestanding Skilled Nursing Facilities (SNFs) from 2001 thru 2011 found that registered nurses (RNs) were less likely to work at nursing homes with high concentrations of racial and ethnic minorities.
A recent report in Pennsylvania highlights some of the public benefits relied on by low-paid workers. The report goes on to describe the positive effects for residents, workers, and taxpayers of increasing the minimum wage for all workers to $15 per hour. Legislation introduced in the Pennsylvania state legislature seeks to do just that, preventing the nursing home industry from shifting the costs of workers’ public benefits to taxpayers.
Former residents at 12 nursing facilities filed a lawsuit challenging the facilities’ chronic understaffing between December 2006 and July 1, 2009.
On May 22, 2015, the country’s largest Roman Catholic health system, St. Louis-based Ascension Health, announced that it would pay workers at least $11 an hour.
Although inadequate staffing is a claim in many negligence and wrongful death lawsuits against nursing facilities, some litigation addresses insufficient staffing directly as the sole issue. Two cases are discussed here.
Although most nursing facilities nationwide do not have sufficient staff to provide necessary care to their residents, an analysis by the Center for Medicare Advocacy (Center) finds that the federal enforcement system cites very few facilities with staffing deficiencies and often does not impose any financial penalties, even when it finds that facilities do not have sufficient staff.