Feds to Investigate as Staffing Impacts Quality of Nursing Home Care
Surprise inspections are scheduled to strike nursing homes after federal officials learned most facilities had fewer nurses and staff on duty than they reported.
The U.S. Centers for Medicare & Medicaid Services (CMS) announced the crackdown in a Nov. 30, 2018 memo to state inspectors.
“Since nurse staffing is directly related to the quality of care that residents’ experience, CMS is very concerned about the risk to resident health and safety that these situations may present,” said the memo from acting director Karen Tritz.
Scrutiny on nursing homes with safety violations
The federal scrutiny was discussed in a Kaiser Health News post the same day Tritz’ memo was released. Abnormally low weekend staffing at some nursing homes will result in more surprise inspections occurring on Saturdays and Sundays.
The CMS will identify nursing homes for which payroll records show low weekend staffing or work shifts that take place without a registered nurse on duty. Medicare will instruct state inspectors to focus on those potential violations during visits.
A nursing home is a place for people who can’t be cared for at home and need 24-hour nursing care, according to the federal government.
Medicare requires nursing homes to have a registered nurse on site for at least eight hours a day. Payroll records show a quarter of nursing homes reported no registered nurses available for at least one day during a three-month period.
Nursing home residents and families complain of trouble finding on-duty staff on weekends for basic help with things like assistance going to the bathroom.
An Ithaca, New York nursing home resident said that weekend staffing was so thin, “it’s almost like a ghost town.”
The gaps between what nursing homes reported to the federal government as their staffing levels and the truth prompted the government to downgrade ratings for 1,402 of 15,600 facilities.
Industry officials said the issue was complicated. Richard Mollot, executive director of the Long Term Care Community Coalition, an advocacy group in New York City, said the new federal order for more surprise inspections was necessary only because state inspectors have not been properly enforcing existing rules.
Mollot asked how many studies are needed across how many years that show nursing homes fail to staff work shifts properly, yet the outcome results in “very few” penalties.
“The basic problem is the states don’t take this seriously,” Mollot said.
CMS said it will identify potential violators by analyzing payroll records that nursing homes are now required to submit. Kaiser Health News analyzed such staffing records and found that they showed lower staffing than what nursing home officials previously reported to inspectors.
The federal plan to increase inspections is the wrong step, a nursing home industry official said. Federal officials should help nursing homes address a workforce shortage facing such facilities instead of taking a punitive approach, said David Gifford, senior vice president of quality and regulatory affairs at the American Health Care Association, an industry organization in Washington D.C.
Records that appear to show staffing shortages could, in fact, be clerical errors that fail to register hours that nurses worked, nursing home officials said.
Contact the Law Office Of George S. Johnson in Georgia today for help with nursing home understaffing or other cases of neglect or abuse at a nursing home or assisted living facility.