Articles Posted in Staffing

The New York Times is reporting this morning that 90% of all nursing homes were cited for violations of federal health and safety standards. Approximately 17% of U.S. nursing homes had deficiencies that caused actual harm. As mentioned in this blog previously, nursing facilities that operate “for-profit” were more likely to have problems than non-profit homes.

Federal inspectors received 37,150 complaints in 2007 about nursing home conditions, the bulk of which involved bed sores, abuse and neglect of residents, medication errors, and nutritional issues. Failure to sufficiently staff was noted as a particular concern in the report, including the allegation that nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.” Not surprisingly, researchers learned that elderly patients receive better care at homes with a higher ratio of nursing staff members to patients.

The U.S. has approximately 15,000 nursing homes, housing nearly 2 million people. Under the laws of most states, including California, these homes are inspected once a year.

I recently attended a nursing conference where the central theme was elder abuse and neglect. One of the presenters was Charlene Harrington, Ph.D. of UCSF, a professor of nursing and sociology, who is considered an expert on nursing home staffing.

According to Harrington the nursing home staffing picture in California isn’t pretty. She said that there are over 12 million deficiencies in U.S. nursing homes annually, and stated that approximately one-quarter to one-third of all nursing homes provide substandard care.

According to Harrington, sufficient staffing is the number one indicator of the quality of care one can expect to receive in a nursing home. California requires that a licensed skill nursing facility provide at a minimum of 3.2 hours of nursing, per patient, per day. While this is a minimum standard, most California facilities view it as the threshold, striving only to meet it. In fact, RN care has been declining in California, which now has one of the lowest RN per patient, per day ratios in the country.

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