New Study Shows Majority of Nation’s Nursing Homes Fail to Meet RN Staffing Requirements

Harvard and Vanderbilt medical schools recently put researchers to the task of examining payroll records from over 15,000 U.S. nursing homes, revealing the staggering truth about registered nurse (RN) staffing. Three-fourths of the nation’s nursing homes never meet federal staffing expectations for registered nurse staffing, and RNs are missing from such facilities on the weekends.

Health Affairs published the study in its July issue in which co-author David Grabowski, a professor in the Department of Health Care Policy at Harvard, said that the conclusions based on a year’s worth of newly logged payroll data, could present much more significant issues in elder care today and well into the future.

“We need to use expected staffing in quality reporting, monitoring, and enforcement,” Grabowski told McKnight’s Long-Term Care News. “CMS needs to address the gap between their expectations and the regulations regarding RN staffing.”

Five Important Take-Aways from the Study

Several things can happen when understaffing occurs, especially that of RNs. Falls, neglect, lazy or null hygiene practices, and medication errors are more likely to occur as well as abuse. Below are five additional take-aways from the report.

  1. 75 percent of SNFs were rarely in compliance with the Centers for Medicare & Medicaid Services’ (CMS) expectations for RN staffing, given their residents’ particular acuity levels.
  2. 70 percent of facilities self-reported false numbers to reflect a higher total in direct staffing.
  3. Reporting, monitoring, and staff enforcement discrepancies were most pronounced at for-profit facilities, followed by non-profits and then government-run buildings such as state veteran’s facilities.
  4. On a massive number of weekends, there was not sufficient RN staffing in most U.S. nursing homes
  5. Facilities with higher five-star overall ratings on Nursing Home Compare or lower shares of Medicaid residents had smaller fluctuations in staffing.

Proving troubling patterns in nursing home staffing can present additional challenges since CMS switched from a self-reported data system to a payroll-based journal (PBJ) log in 2018. The authors concluded that the PBJ data they reviewed and used in the study carries the potential of more accurate public reporting and improved nursing home resident outcomes.

For-profit homes cry that employing staff and pushing up labor costs only leads to widespread budget increases (and less fattening of private pockets), but shortages can ironically do the same. But nursing homes must be honest in their reporting, increase the pay of those caring for a greater share of residents on the weekends, and RN staffing numbers must meet the measures established by CMS and be tightly regulated. Only then will the quality of resident care improve, and fewer occurrences of elder abuse and neglect occur.

Report RN Staffing Issues and Speak with a Lawyer

At Levin & Perconti, we frequently have care workers contacting our attorneys to share concerns or report violations of the Illinois Nursing Home Care Act. If an employer retaliates against an employee in violation of the Nursing Home Care Act, the affected employee may bring a civil action against the employer for multiple types of relief.

Consultations with our attorneys are both free and confidential. Please call us at (312) 332-2872 or complete our free online consultation request form.

Also read: Nursing Homes Are Not Reporting Abuse