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Nursing Home Staff Levels Are Lower Than Reported

Published on Nov 28, 2014 at 2:54 pm in Nursing Home Abuse.

We’ve reported earlier on this blog about flaws with the federal government’s reliance on nursing homes to self-report their staffing levels. This system has lead to homes padding payrolls, adding temporary staff right around inspection time only to lay them off soon after.

Now the Center for Public Integrity has done its own auditing and found that thousands of nursing homes have inflated their staff levels to the Nursing Home Compare website run by the Centers for Medicare and Medicaid Services (CMS).

The levels shown on the Nursing Home Compare website were higher than the staff levels the Center for Public Integrity found by looking at annual financial reports submitted by the homes. Those documents contain revenue and expenditure data, along with resident population, which allow a precise calculation of staff to resident ratios.

The Center found discrepancies for all types of staff positions, but the gap was especially high for registered nurses. Among the findings:

  • More than 80% of homes posted higher RN levels on the public website than they disclosed in financial reports to Medicare.
  • More than 25% of homes listed an overall staff level on the public website that was at least twice the level they disclosed in financial reports to Medicare.
  • Gaps were found in nearly every state, but 8 of the 10 states with the widest discrepancies were in the South.

These falsely reported numbers mislead families when choosing homes to place their loved ones. The CMS established the Nursing Home Compare website to give consumers information when looking for a nursing home. CMS also uses the self-reported staffing numbers when calculating its one-five star quality rating for nursing homes.

The Center for Public Integrity noted the significance that the staffing position most often inflated was that for registered nurses. RNs are the most skilled and highest paid workers at nursing homes. The Center emphasized: “Studies show that the amount of care, especially by registered nurses, is strongly connected to the quality of care.”

CMS has previously stated that it would start using more accurate data for staffing reports by March 2012, but it didn’t meet that deadline; now it says it might take another two years.

In response to the findings, a spokesperson for the National Consumer Voice for Quality Long-Term Care, an advocacy group, told the Center: “We all recognize the data is flawed, but I am truly stunned by [the] findings and appalled that you’re finding this level of over-reporting.”