Most Nursing Homes Overstated Size of Staff, Federal Data Shows

Choosing a nursing home for an elderly relative can be a difficult task, as families want to ensure their loved one will receive the care and support they deserve. Often, the search for the right home will require families to carefully evaluate facilities, administrators, and their staff, asking important questions about the quality of care they provide and researching publically available information about them. Though that public information may be on government websites and relied upon by families when choosing a nursing home, it may not always be true, according to new federal data.

In a recently published health article, The New York Times discusses how the data shows most nursing homes in the U.S. have less nurses and caretakers than they had reported to the federal government. For the first time, the records provide a comprehensive view of nursing home staffing. The information was compiled through review of new Medicare payroll records from over 14,000 nursing homes that have only been gathered since the passing of the Affordable Care Act. Here are a few important findings from the report:

Because Medicare’s five-star rating system had previously ranked nursing homes using self-reported and unverified staffing numbers, overstating the size of a facility’s staff made it possible for nursing homes to game the system, and make themselves appear more attractive to prospective families. However, that deceit can have tremendous consequences for the families and residents who were misled into choosing understaffed facilities.

As profiled in the NYT article, one nursing home resident explained how weekends at his nursing home can seem like a ghost town, and how he often needs to search the facility in order to find an aide to assist him with tasks like getting dressed. This experience is unfortunately not uncommon, and is the very same problem that can lead to residents suffering serious harm.

Inadequate Staffing & Nursing Home Injuries

Inadequate staffing can compromise the quality of care provided to nursing home residents,and substantially increase their risks of suffering preventable nursing injuries or death. That’s due to a number of factors, including:

  • Low staffing can lead to overburdened nurses and aides who must take on additional tasks and duties, from delivering meals to numerous residents to transporting them to the restroom, answering calls, and providing individualized medical care.
  • Increased workloads on staff can be especially dangerous when it comes to essential medical tasks and providing residents with treatment or medications, as over worked staff are more likely to forget or miss tasks and make mistakes when performing them. This short staffing can manifest in the form of medication errors or failing to reposition patients to avoid bedsores and infections.
  • Gaps in the amount of staff on duty, such as during nights or weekends, exacerbate problems of overburdened staff and increase patient risks, even when the needs of residents remain the same on weekends as they do on weekdays.
  • Insufficient staffing makes it more likely for delays in addressing medical emergencies and providing the treatment or emergency medical information residents need, sometimes in life-or-death situations.
  • Inadequate staffing makes it less likely for aides to identify signs of abuse involving other staff and residents and signs of neglect that affect their health and quality of life, including malnutrition, dehydration, and behavioral changes.
  • Overburdened staff may be more susceptible to fatigue, stress, and other factors that can contribute to mistreatment of residents or emotional abuse.

While Medicare does not currently enforce a minimum ratio when it comes to the number of available staff per resident, it does require facilities to have a registered nurse on duty for at least 8 hours a day, and a licensed nurse around-the clock. Still, it is the responsibility of nursing homes to ensure that staffing is sufficient enough, and qualified enough, to address foreseeable risks and provide an acceptable level of care. One facility positively rated for its staffing levels had a 1-to-8 ratio` of aides to residents on its best staffed days, and only one aide for every 18 residents on its lowest staffed days. Levels of nurses on duty also varied dramatically.

In response to the new findings, the Centers for Medicare and Medicaid Services has stated that it is taking steps to address staffing issues and fix its rating system. This change includes lowering ratings for nursing homes which went 7 or more days without having a registered nurse on duty. While these are steps in the right direction, inadequate staffing will likely continue without additional regulations and stronger requirements for numbers of staff and nurses, steps which have been supported by health inspectors for several years. When short staffing causes residents to suffer preventable injuries, victims and their families have the right to hold nursing homes accountable for their failures and negligence by filing civil lawsuits.

At Spangenberg Shibley & Liber LLP, our Cleveland nursing home injury attorneys represent victims and families throughout the state for preventable injuries and deaths in assisted living facilities, including those caused by neglect and abuse. Our attorneys are passionate about protecting the rights of families, especially when the families were led to believe that the nursing home they chose would uphold their obligations to provide an acceptable standard of care.

If you have questions about nursing home injury lawsuits, your rights, and how our legal team may be able to help you obtain the justice and compensation you deserve, contact us for a free consultation. Our award-winning lawyers at Spangenberg Shibley & Liber LLP proudly serve clients throughout Cleveland, the state of Ohio, and beyond.


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