JustCare

Tag: Staffing

  • When looking into nursing home care, ask about staffing levels

    When looking into nursing home care, ask about staffing levels

    The vast majority of Americans would prefer to age in place–live out their lives in their homes. But, 1.3 million older Americans do not have the supports they need to age in place and end up living in a nursing home. In an opinion piece for the New York Times, Norma B. Coe and Rachel M. Werner explain why rules regarding adequate nursing home staffing literally saves lives.

    Today, under federal law, nursing homes must have a minimum staff level that ensure that around 13,000 nursing home staff do not endure a premature death and thousands more do not end up with bed sores and urinary tract infections. Even though these rules increase the costs of care in a nursing home, the Trump administration should stand behind them.

    Robert F. Kennedy Jr. is likely to be the next head of the US Department of Health and Human Services. In his confirmation hearings, he made clear his opposition to these nursing home staffing rules. Contrary to his claim, rural hospitals can get exemptions from these requirements if they cannot find staff to meet them. RFK Jr.’s misplaced views aside, Republican attorneys general have brought a lawsuit to end these rules.

    The federal nursing home rules ensure nursing-home owners are able to provide residents with adequate care. A registered nurse must always be at the nursing home and nursing aides must be available for a few hours of care daily for each patient. In more than 80 percent of nursing homes, that was not the case in early 2023, before the staffing rules took effect.

    If you’re looking into nursing home care for yourself or others, always ask about nurse and nurse aide staffing levels. With more nurses and nurse aides, residents tend to get better care and live longer. They get fewer bedsores and urinary tract infections.

    For-profit chain nursing homes tend to have poor staff levels. Ninety percent of them did not comply with the minimum standards. About 60 percent of non-profit nursing homes also did not meet standards.

    Only about one in five nursing homes in the United States meet basic minimums. The for-profit ones claim low profits, but that is extremely misleading. The owners too often hide their profits through subsidiary companies they overpay to provide nursing home services or to rent the facility.

    The US is an aging society. Americans over 65 currently represent 17 percent of the population and will represent 22 percent by 2040. If we care about our elders, we should ensure they are being properly care for.

    Here’s more from Just Care:

  • New nursing home staffing requirements are a step forward

    New nursing home staffing requirements are a step forward

    It has become increasingly clear that our federal government is not willing or able to enact laws and rules that go as far as necessary to protect consumers. Recently, the Centers for Medicare and Medicaid Services (CMS) issued final rules with regard to nursing home staffing requirements that are a huge step forward and yet not nearly enough, Jordan Rau reports for KFF Health News. Patient safety and adequacy of care remain a concern, even with these rules. 

    Under the new rules, most of the 15,000 nursing homes in the US will have to hire more nurses and aides, beginning in 2026. The nursing homes will, on average, need to offer 3.48 hours of care each day to each resident. Today, some four in ten nursing homes do not do so. But, many advocates do not believe that these rules will ensure that nursing homes deliver high quality care.

    Without a higher ratio of nurses and aides to nursing home residents, it is challenging for nursing homes to care for their patients, as we saw during the Covid epidemic. Instead, residents end up with bedsores, fall needlessly, are not properly diagnosed for their conditions or take more trips to the emergency room.

    At the moment, it’s not clear whether there are enough nurses and aides available for nursing homes to hire. Nursing homes tend to pay less for nurses than hospitals. And, aides can often earn more working in restaurants. If the worker shortage remains, the nursing homes will likely not comply with the new rule.

    CMS projects that its rules will cost nursing homes $6 million more a year. CMS does not plan to increase Medicare and Medicaid payments to cover these additional costs. The nursing home industry calls it an “unfunded mandate” and intends to see if it can persuade Congress (or likely the next Administration) to undo it.

    And, still, CMS is calling for nursing-home staffing levels that are less than excellent, according to the head of the Long Term Care Community Coalition. The rule is a step forward because the previous rule was not specific as to what constituted a “sufficient” staffing level, only that the staffing level be “sufficient.”

    To date, the Office of the Inspector General has found that many nursing homes do not meet many basic staffing requirements.

    Critics of the new CMS rule argue that it will lead to many nursing home closures as nursing homes will not be able to hire more workers. Both the cost of hiring them and the scarcity of workers present obstacles. But, a recent study found that, overall, nursing homes are doing extremely well financially. Owners are able to secure substantial profits through all kinds of shenanigans. A while back, the Kaiser Family Foundation explained how owners profit and advised avoiding chain nursing homes.

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