Researchers from Harvard and Vanderbilt medical schools examined records from 15,399 nursing homes covering April 2017 through March 2018. Their results were published online by Health Affairs.
They found that three-fourths of the nation’s nursing homes never meet federal staffing expectations for registered nurse staffing, and RNs are often missing from such facilities on the weekends, according to a new review of a year’s worth of payroll data. The research also found that 70% of facilities self-reported higher total direct staffing under the CASPER system than in the now-standard Payroll-Based Journal. The discrepancy was most pronounced at for-profit facilities, followed by non-profits and then government-run buildings.
While PBJ data proved 96% of nursing homes had an RN onsite for at least eight hours a day 80% of the year, the weekends told a different story. For RN staffing, 91% of facilities met the expected level less than 60% of the time. Overall staffing also was lower on the weekends, with reductions in LPN and nurse aide hours too.
Adverse events such as falls and medication errors might be more likely to occur during those understaffed days,” the researchers wrote. “For this reason, CMS should leverage the daily payroll data to incorporate staffing variation over time, in addition to average staffing levels, in its calculation of star ratings.”
SafeLight care validation platform is based on an IOT implementation of the STRIVE study and focuses on missed care episodes rather than absolute staffing numbers. Our data consistently proves that it is not the number of staff but the quality of care delivered by the caregivers that ultimately matters to insurers, operators and family members.