Insufficient Staffing at Nursing Homes

Residents of nursing homes are all too often the victims of abuse, neglect and substandard care. Federal standards (Nursing Home Reform Law) mandate that every resident is entitled to the highest practicable level of physical, mental and psychological well-being. Regrettably, there has been a significant rise of violations of residents’ rights over the last several years.

One theme that appears to predominate this trend is insufficient levels of staffing. This leads to our most vulnerable citizens suffering needless pain and humiliation.

Our friends at the Long Term Community Coalition recently published a policy brief that reviewed and assessed the impact that low staffing has nursing home quality and safety.

An Assessment of the Impact of Low Staffing Levels on Quality of Nursing Home Care in New York. This policy brief provides a review and assessment of the relationships between staffing levels in New York State (NYS) and key indicators of nursing home quality and safety. Following are some of the important observations from this report:

• Pressure Ulcers. As the total staffing rate increases, the pressure ulcer rate tends to decrease. Within most facilities, pressure ulcer rates are high and remain high until staffing levels reach four hours per resident per day (HPRD). Between 4-6 hours HPRD, pressure ulcer rates decrease rapidly.
• Antipsychotic Drugging. The data indicate a negative relationship between average total staffing HPRD and antipsychotic drugging. In other words, as total staffing goes up, antipsychotic drugging goes down. This is particularly true among the majority of nursing homes with between 2-6 total care staff HPRD.
• Substantiated Complaints. As the average RN staffing hours per resident per day increases, the number of substantiated complaints tends to decrease at a substantial rate through about 2.2 HPRD (encompassing approximately 97.5% of all nursing homes).

Let us emphasis that this is not a reflection on those people who work in nursing homes. Most are dedicated and hardworking. However, they are being pushed to the limit and not provided with appropriate support.