'It's Almost Like a Ghost Town.' Most Nursing Homes Overstated Staffing for Years

[DonViejo]

By Jordan Rau
July 7, 2018

191
ITHACA, N.Y. — Most nursing homes had fewer nurses and caretaking staff than they had reported to the government for years, according to new federal data, bolstering the long-held suspicions of many families that staffing levels were often inadequate.

The records for the first time reveal frequent and significant fluctuations in day-to-day staffing, with particularly large shortfalls on weekends. On the worst staffed days at an average facility, the new data show, on-duty personnel cared for nearly twice as many residents as they did when the staffing roster was fullest.

The data, analyzed by Kaiser Health News, come from daily payroll records Medicare only recently began gathering and publishing from more than 14,000 nursing homes, as required by the Affordable Care Act of 2010. Medicare previously had been rating each facility’s staffing levels based on the homes’ own unverified reports, making it possible to game the system.

The payroll records provide the strongest evidence that over the last decade, the government’s five-star rating system for nursing homes often exaggerated staffing levels and rarely identified the periods of thin staffing that were common. Medicare is now relying on the new data to evaluate staffing, but the revamped star ratings still mask the erratic levels of people working from day to day.

more
https://www.nytimes.com/2018/07/07/health/nursing-homes-staffing-medicare.html

[mainer]

1. Immigrants once staffed many nursing homes and hospitals

Filipina nurses and aides made up the bulk of staff in some hospitals I once worked in. I wonder if that's still true. And I wonder if this staffing shortage will only get worse as we clamp down on immigration.

[left-of-center2012]

3. "Immigrants ..."

I recall a time in either the 1970's or 1980's when a lot of nurses from Ireland were coming here to work,
due to a nursing shortage.

As for nurses from the Philippines,
I think there's some special (legal) relationship with them as a result of our taking them from Spain during the
Spanish-American War.

“... in December 10, 1898, the Treaty of Paris was signed which ceded the Philippines from the Spain to America.
... the Treaty of Manila (was) signed on July 4, 1946. The treaty granted the Philippines "full independence" from the United States of America.”
https://www.quora.com/When-did-Philippines-gain-independence-1946-or-1898

[TexasBushwhacker]

7. Nurses from the Phillipines are common because they generally speak English well

The Phillipines has a number of dialects so English is taught as a second language for all Filipinos. It isn't unusual for Filipinos from different parts of the country to converse in English. Tagalog is the most common language in the Phillipines, but us the first language for only about 25%.

[exboyfil]

2. Have they done a full accounting of these facilities

It would be very interesting to see where the money goes. I know our county run nursing home is in the red and has to be subsidized by the county (there is talk of selling it off). The business model that appears to be happening in our non-profit run homes around me is one in which they offer tiers of service. The highest tier, which is paid for by the assets and insurance of the upper middle class and wealthy, serves to subsidize in part the care for the Title 19. I know that my grandma was Title 19 and got excellent care at her nursing home (she lived ten years there at a cost to Medicaid of over $500K). A fair amount of the support for the patients came from volunteer effort as well. She had to share a room, but they did continually maintain her room and even upgraded it over time (including wall mounted televisions). They also updated the patient care equipment while she was there. It was interesting because we first saw this equipment at the University of Iowa Hospitals when my daughters were there for Girl Scouts.

My entire family on my grandma's side are Trump supporters. They don't like it when I mention that the US taxpayer kicked in $500K for my grandmother's support. They go on about how she and my grandpa paid that in taxes. I mention those taxes were for the aircraft carriers and such, and they didn't cover everything else.

[left-of-center2012]

4. Phantom staff

I worked a nursing home in San Diego for a while in the 1970's.

Somehow we always knew when the state would show up for inspections,
and our sign-in sheets contained extra names of aides who never showed up
but got counted as 'on duty'.

[blueinredohio]

5. I also worked in a nursing home in the 70"s and 80"s

We always did everything by the book when state was coming and we always knew when they were coming. That's why I always said I would never do that to my parents if I could take care of them. Thank goodness they were taken care of at home.

[Runningdawg]

6. There are few RNs who work in nursing homes anymore

90% of the work is done by aides who took a weekend course. After working with a lady who had recently been released from prison, I discovered getting accepted to the class in prison is considered the golden ticket - A good paying job that gives you access to personal belongings and drugs galore and supervisors that don't care if you do the work or not because they can always blame it on - being understaffed.