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Understaffing in Nursing Homes: A Cause for Concern

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Under the Affordable Care Act of 2010, over 14,000 nursing homes were recently required to start providing payroll records to the government, which serve as indicators of staffing levels. Kaiser Health News analyzed the records and found that most nursing homes are operating at consistently understaffed levels, and some facilities even falsely reported having more staff on hand than they actually did.

Apart from across the board understaffing, the study discovered that on weekends, nursing homes see an even larger deficit in adequate staffing than during the week. At worst, a nurse or aide may be required to care for twice as many patients as he or she would on a day with more personnel.

Throughout the week, when staffing levels are typically at their highest, most aides were found to be responsible for anywhere from nine to 14 residents. On the weekend, that number goes up, as nursing staff drops roughly 11 percent on average, and aide staff drops roughly 8 percent.

Even in day-to-day operations, staffing levels fluctuate at a significant rate. Though it is mandatory for a licensed nurse to be at the facility at all times and a registered nurse to be on site for eight hours a day, some homes reportedly went a day or more without having a registered nurse present.

Predominantly, low wages and high rates of turnover are cited for staffing deficiencies. When a facility is already understaffed, nurses and aids are overworked and frequently burn out, which leads to a high rate of turnover. Essentially, a vicious cycle ensues, where underpaid, overworked employees have little motivation and insufficient time to provide the quality of care needed.

Unsurprisingly, one of the biggest concerns with short staffing in a facility is quality of care. As workers are continually assigned a higher volume of residents, meeting their needs promptly, or at all, becomes a challenge. Even tasks such as feeding, assisting the resident to the bathroom or frequently rotating the patient to avoid pressure sores can be neglected.

Most understaffed facilities are plagued by more frequent health code violations as well.

Though Medicare does not require a facility to have a minimum number of employees, in order to address rising concerns, the Centers for Medicare & Medicaid Services declared it would lower a nursing home’s star rating if it goes seven or more days without a registered nurse on hand. In addition, it said in a statement that it “is concerned and taking steps to address fluctuation in staffing levels.”

Understaffing in nursing homes can significantly and severely affect a resident’s quality of care. Basic tasks may be neglected, as fewer staff members are present to assist residents. At Jehl Law Group, many of the cases we have handled and continue to handle are, in part, due to short staffing.

We know the pain of seeing a loved one suffer and have successfully fought for victims of understaffed nursing homes. If you or someone you know has been neglected, please contact us for a free consultation.