Websites like the Centers for Medicare Services nursing home rating website previously relied on self-reported staffing levels for their rating. In accordance with the Affordable Care Act of 2007, CMS is supposed to use payroll proof to render their ratings. However, this has been slow to occur, particularly in California. Now that payroll records are dictating staffing levels, it is coming to the attention of advocacy groups that many nursing homes in California may be woefully understaffed. California Healthline reports on the story.
There currently is no consensus on optimal staffing levels for nursing homes. Medicare rebuffed requests to create minimum staffing policies, stating that their preference was to leave such matters to each individual facility based on the needs of their residents.
In April, the government changed the way in which ratings for staff levels were calculated, taking the number from payroll records rather than allowing homes to self-report, as they previously had been able to do. However, even that can create a false sense of being adequately staffed, since records are only checked for the two weeks prior to the inspection. This can allow nursing homes to ramp up staffing prior to an inspection that they may know is coming and decrease staffing at other times.
One Ithaca, New York facility called Beechtree had only one aide for every eight residents on its best-staffed days. On the worst-staffed days, which were typically weekends, that number fell to one aide for every eighteen residents.
One resident, who entered Beechtree after a stroke paralyzed his left side said that “It’s like a ghost town” when asked about staffing.
As stated above, Medicare does not have a minimum staffing requirement for aides. The agency, however, does require the presence of a registered nurse for at least eight hours a day. They also require that a licensed nurse be available at all times.
It should be noted that Beechtree’s staffing levels remained similar in both the old and the new reporting requirements.