Nurse Staffing Ratios in Long Term Care Facilities

Nurse staffing is often a hot button for skilled nursing facilities. The need to balance costs with care occurs on a daily basis. For the nursing administrator, the ability to make a case for staffing increases often rests on the ability to provide solid rationales for the increased personnel costs.

CMS Findings on Staffing

The Centers for Medicare and Medicaid Services (CMS) issued a comprehensive report in that focused on nurse staffing in nursing facilities, including skilled nursing facilities and other long term care facilities. At that time, 97 percent of facilities did not have sufficient nursing staff to meet one or more federal staffing requirements or to prevent avoidable harm to residents. In addition, 91 percent didn’t have sufficient nursing staff to meet five important process requirements – dressing/grooming, exercise, feeding assistance, changing wet clothing and repositioning, and toileting. The Center for Medicare Advocacy (CMA) notes, “The report found insufficient numbers of professional nurses as well as insufficient numbers of aides. Although resident acuity has increased in the decade since the CMS report was issued, staffing has not significantly changed, in terms of either absolute numbers of nursing staff or the professional qualifications of staff.”

Further, CMA notes that reduction of unnecessary hospital readmission is one of the goals of health care reform. Recent data from the Centers for Disease Control and Prevention indicates that eight percent of nursing home residents in the US had an emergency department visit in the previous 90 days. Eighteen percent of that number had two or more visits.

Forty percent of those visits were found to be preventable. Falls – previously found to be directly linked to staffing ratios – were the most common reason for nursing home residents to be admitted to the emergency room.

Since 2015, CMS has been collecting and reporting data on all-cause 30-day readmission rates for long-term care facilities across the US. Beginning in fiscal year 2019, long term care facilities will receive incentive payments based (Skilled Nursing Facilities Prospective Payment System (SNF PPS)) which are tied to the quality of the care and the re-admission rate to acute care facilities.

To find out more information on how using appropriate staffing levels can increase Long Term Care Facility reimbursements, check out “How Staffing Makes a Difference”

References:

https://medicareadvocacy.org/more-nurses-in-nursing-homes-will-mean-fewer-patients-headed-to-hospitals/

https://medicareadvocacy.org/preventable-emergency-department-visits-by-nursing-home-residents/

https://www.cdc.gov/nchs/data/databriefs/db33.pdf

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/SNF-VBP/Downloads/SNFRM-TechReportSupp-2019-.pdf

 

 

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