If you ask any patient advocate what can be done to improve nursing homes, one of the answers will be increasing the number of care staff. Providing enough attention to patients, especially those with acute medical needs, has long been an issue in these facilities. Unsurprisingly, homes with fewer nurses provide worse care. While families now have more access to information about nursing home staff levels, they are still constricted by location, availability, and other factors that may bar them from placing loved ones in higher-rated facilities.
Though staffing concerns have for years seemed abstract to many, COVID-19 has made it clear nursing homes must be regulated to ensure our elders receive the care they need. It’s too late to prevent the tragedy that’s unfolded over the past year, but we can act now to stop the next infectious disease from taking so many.
What Is the Recommended Level of Staffing for Nursing Homes?
Since the Centers for Medicaid and Medicare Services (CMS) released a 2001 study laying out recommendations for staff levels at nursing homes, the industry has known what it takes to provide adequate care. The paper showed the importance of having a minimum of 4.1 nursing hours per resident every 24 hours, with at least .75 of those hours provided by a registered nurse (RN).
Further research has suggested residents should receive 4.55 hours of nursing care every day, with an RN available 24/7 and 30% of care provided by RNs and licensed vocational nurses (LVNs) or licensed practical nurses (LPNs).
Nursing Home Staffing Deficiencies Are Everywhere
Despite this widespread knowledge, 3 out of 4 nursing homes do not meet minimum staffing standards, to the detriment of their patients. The state of Maryland only requires nursing homes to provide residents with 3.0 hours of care each day. Other states do not even have requirements, allowing nursing homes to decide their own staffing needs—even when this means patient care is no longer the top priority.
Many for-profit nursing homes skimp out on staffing so they can benefit shareholders. As nursing home staff levels are the highest indicator of the quality of care residents will receive, these facilities are likely to have lower ratings and more safety violations. Everything from pressure ulcers, restraint use, and dehydration to, yes, infection rates, can be decreased by higher RN-to-patient ratios.
New York AG Cites Understaffing As COVID-19 Risk
Attorney General Tish James of New York issued a report at the beginning of 2021 blaming high COVID-19 death rates at nursing homes on a lack of adequate staffing. Now that we know New York’s fatalities were even higher than we thought, the need for change is clear. According to reporting by the New York Daily News, of New York’s 617 nursing homes, nearly 70% do not meet the care standards set by CMS. This is lower than the national average, but still a devastating number.
We’ll never know how many lives could have been saved if facilities had provided the care patients needed, but even if it was only one, the extra effort would have been well worth it. With hundreds of thousands of families grieving nationwide, our healthcare system is due a serious re-evaluation.
Legislators in New York have once again started discussing regulations to set minimum staffing levels in the state. Though nursing home lobbies have fought back against the idea in the past, there may now be enough public support to make real change.
Explicit Links Between COVID-19 Levels and Understaffing
The data on staffing is clear, with over 150 studies agreeing more nursing hours per patient per day is linked to better care. In the past year, we’ve also seen major efforts to determine how staffing affects the risk of COVID-19.
Coast to coast, researchers found correlations between the number of COVID-19 cases and fatalities and a nursing home’s staffing ratios. In California, nursing homes that provided less than the recommended .75 hours of RN care per patient per day were twice as likely to have patients with COVID-19. A study done the University of Rochester Medical Center that looked at staffing levels in Connecticut facilities also found a link between lower levels of care, especially RN care, and COVID-19 cases. Said one of the study’s authors, “In most nursing homes, RNs are the linchpin for the assessment and provision of medical care.” Especially during a deadly outbreak like the COVID-19 pandemic, it’s clear nursing homes should be looking to increase RN hours for the safety of their residents.
Addressing Insufficient Care in Nursing Homes
COVID-19 may be the first global pandemic most of us have experienced, but deadly infections are not new to nursing homes. There was plenty of warning that we might find ourselves in this situation. Nursing home owners that made the choice to understaff their facilities should be held accountable for the way their decisions have affected thousands of families nationwide.
Brown & Barron, LLC continues to fight for the victims of nursing home abuse and neglect. If insufficient care resulted in your loved one developing COVID-19 or another serious viral infection, we can help you determine whether you may be able to file a claim. Until our government steps up to make nursing homes provide the level of care patients deserve and families expect, we’ll continue to fight for those who suffer.
Call us today at (410) 698-1717 to schedule a free consultation with our experienced nursing home abuse attorneys.
