Staffing is Key

When picking a nursing home, I find as a nursing home lawyer Trenton, NJ trusts, many people suffer from a lack of information and don’t really know what to ask when choosing a facility.  In my experience staffing levels are the most important issue in cases we prosecute. This is not just my opinion. We can look to the authority on nursing homes – the Center for Medicare and Medicaid Services (CMS).

CMS is the biggest payor for nursing homes in the United States.  They write the federal regulations that set the minimum standards nursing home are required to meet, and well as conduct studies about nursing home staffing levels and quality of care.  They collect a tremendous amount of information regarding nursing homes.

Based on the staffing study, Medicare has found:

“There is considerable evidence of a relationship between nursing home staffing levels, staffing stability, and resident outcomes” and “a clear association between nurse staffing ratios and nursing home quality of care, identifying specific ratios of staff to residents below which residents are at substantially higher risk of quality problems.”

It is for this reason that Medicare tracks facility staffing.  You can get this information at the Medicare Nursing Home Compare website.

https://www.medicare.gov/nursinghomecompare/search.html?

This website is designed for people who are looking to place their loved one in a nursing home.  Each facility will get a one to five start rating with five being a good score, and one being a poor score.  The underlying sub-categories of the overall star rating are Health Inspections, Quality of Care, and Staffing.

A facility that received one star for staffing will struggle to deliver the care necessary to it’s residents.  There are simply too many people to do what needs to be done.

In these scenarios, we see bed sores from not enough people to simply turn and reposition residents, falls due to lack of supervision, undiagnosed infections due to lack of nurses, and malnutrition and dehydration due to lack of aides to feed residents that require help.    

While the star rating is certainly helpful, there is sometimes other staffing data available depending on the state where you live.  For example, in New Jersey nursing homes are required to report quarterly staffing ratios to the Department of Health, which are made publicly available.  You can find that information at:

https://www.nj.gov/health/healthcarequality/health-care-professionals/nurse-to-patient-staffing/background/nhstaffing.shtml

This is a helpful tool because it compares a facility’s staffing ratios against the state and national average for the same time period.

A powerful new tool recently developed by Medicare regarding staffing levels is the Payroll Based Journal system (PBJ).    The data is available for nursing homes from 2nd Quarter 2017 until today.  Because CMS has long identified staffing as one of the vital components of a nursing home’s ability to provide quality care, under Obama Care nursing homes now have to submit to Medicare daily staffing and census information.

The nursing staff categories include director of nursing, registered nurses with administrative duties, registered nurses who provide hand-on care, licensed practical nurses with administrative duties, licensed practical nurses who provide hand-on care, certified nurse aides, medication aides, and nurse aides in training. You can find the daily staffing data here:

https://data.cms.gov/browse?q=payroll%20based%20journal&sortBy=relevance

First, click on the “View Data” button.  Next, simply search for the facility you want and you will get the daily data 50 rows at a time.

When choosing a nursing home, you want to be armed with as much information as possible.  Staffing levels are key. Getting the publicly available data can be a great first step towards avoiding a terrible outcome.

 


 

Thanks to our friends and contributors from Davis & Brusca, LLP for their insight into nursing home cases.