Nursing Home Staffing Levels: How Much Is Enough?

During the week of February 17, 2002, headlines screamed the news - more than 92% of US nursing homes fail to have an adequate number of staff to provide quality care for elderly residents. Newspapers and radio programs based their stories on the new study the Health Care Financing Administration (HCFA) recently provided to the Senate's Special Committee on Aging.

Interesting findings led us to reexamine our current data set of nursing home deficiencies. What we found may surprise you; there was no relationship between the level of staffing and the number of deficiencies reported for nursing homes. However, there was a relationship between level of staffing and percent of residents with pressure sores and physical restraints.

This article is provided to you so you'll have a greater understanding of what these findings mean.

The HCFA Study

Purpose - HCFA's study was performed at the request of the Senate's Special Committee on Aging to determine what minimum level of nursing home staffing was required in order to provide quality care.

Findings - The study reported that a minimum level of staffing, determined to be 2.9 hours of Certified Nursing Aide (CAN) time per resident was required for quality care. A number of measures went into this finding. Among them, a time and motion study examined the time required for basic services such as dressing and toileting.

A correlational study that examined the relationship between pressure (bed) sores and staffing found that a higher level of staffing was related to lower levels of pressure sores. This study was somewhat limited by the fact that homes with very low levels of staffing refused to participate; it may be inferred that the correlational findings would have been stronger with the participation of these homes.

In addition, the HCFA study examined the accuracy of reported level of staffing in survey and cost reports. They found that cost reports were more accurate than survey results in reflecting an accurate level of staffing as determined by nursing home payrolls.

Limitations - The report was limited by the extent of the data gathered (3 states included) and may not be generalizable across all states.

When Should Staffing Concern You

When the best is yet.net began examining long-term care, we attempted to gather data on staffing and found that it was extremely difficult to acquire accurate information. Then a well-respected administrator advised us that while staffing was important, it was not as good as measure of quality as the level of care residents actually received. We have learned through experience how right his advice was.

So what should you look for when determining the quality of care residents receive?

• Look for residents who are well groomed and not lethargic.

• Look for residents actively engaged in activities; although each nursing home is required to have an activities director, this does not mean that scheduled activities actually occur.

• Check the latest survey ratings for the percent of residents with pressure sores. Look for a rating close to zero. We also suggest that you examine the percent of residents with physical restraints because physical restraints may be used as a substitute for staff. Again, look for a rating close to zero.

• Look for the quality of interactions between staff and residents. Even though a minimum level of staffing is required for quality care, merely having staff at that level does not guarantee quality care. Homes may have high numbers of staff that do not interact appropriately with residents.

• Listen for reactions to resident complaints. Staff who ignore requests and complaints are not providing quality care.

What You Can Do to Find Good Care

• Check nursing home ratings and visit only those with few or, still better, no deficiencies.

• Call your state's long-term care ombudsman to get information on resident/family complaints. Although these complaints are not standardized and may include wide variations in severity, a large number of complaints should warn you away from homes receiving them.

• Consider non-profit care first. In general, non-profit homes have fewer reported deficiencies and higher levels of staffing than do for-profit homes.

What Else Can You Do?

The current growth in an aging population means that more and more people will require long-term care unless we do something about it now. That something becomes very personal for those of us in the Baby Boomer generation who will, within a few years, be part of the generation potentially needing nursing home care.

So, how's your health? Do what you can to ensure that your later life will not be complicated by any of the three leading causes of nursing home stays: heart disease, stroke and cancer.

About The Author

Phyllis Staff, Ph.D. - Phyllis Staff is an experimental psychologist and the CEO of The Best Is Yet.Net, an internet company that helps seniors and caregivers find trustworthy residential care. She is the author of How to Find Great Senior Housing: A Roadmap for Elders and Those Who Love Them. She is also the daughter of a victim of Alzheimer's disease. Visit the author's web site at http://www.thebestisyet.net

pando19@yahoo.com

---

As the Baby Boomers Age

Many employees today are calling in sick - not to... Read More

Retiring Abroad and Leaving the Grey Skies of the UK

Retiring abroad needs careful planning. Not all countries have the... Read More

Just Give Them a Lot of Love and You?ll be Fine

It was right about this time, 19 years ago. My... Read More

5 Myths You Should Know Before Choosing Elder Care

Myths associated with selecting quality nursing home care suggest quick... Read More

Helping Caregivers Get Comfortable Asking For Help

Becoming a care giver might not have been a conscious... Read More

Compare Nursing Homes

Finding the best nursing home is easier than you might... Read More

Second Hand Stair Lifts

Buying second hand stair lifts is a viable and cost... Read More

Whos Gonna Take Care of You When Youre Old?

I finally went to the doctor this morning for my... Read More

Introducing the Best Available Long Term Care Policy Guarantee

If you're 60 to 70 years old ... or have... Read More

The Right Wheelchair Accessories Will Ease Your Life and Your Journeys on Wheels

Wheelchairs come in every shape and size with sufficient options... Read More

Baby Boomers: Will They Be Able to Afford Their Parents?

Do you worry about whether your aging parents have their... Read More

The Dryer Ate Your Underwear!

Q: My mom is in the early stages of dementia... Read More

Review of the Changing Protein Requirements for Seniors

Youth, it is said, is wasted on the young. Too... Read More

When Assistance with Long Term Care Becomes Necessary

According to the Administration on Aging, it is estimated by... Read More

Arizona Senior Housing: Care Options for Seniors Who Can No Longer Live Alone

The following are a few of the care options available... Read More

Using The Proper Wheelchair Will Make Your Everyday Life Easier

If you have an injury or a health problem that... Read More

Skilled Nursing Homes - What Are They?

A skilled nursing home is a medical facility providing services... Read More

Local Businesses Serving Seniors Prove Commitment to Quality Care

Good news! You no longer have to risk chance when... Read More

Mom Wont Participate!

Q: Six months ago we placed my mother in an... Read More

Arizona Assisted Living: Resident Rights

According to the Arizona Administrative Code (R9-10-710), those who reside... Read More

Long Term In-home Care Options

Are you worried that you may lose all your life's... Read More

Nursing Home Staffing Levels: How Much Is Enough?

During the week of February 17, 2002, headlines screamed the... Read More

Who Wants to End Up in a Nursing Home? NO ONE!

As a long-term care consultant for seniors and their families... Read More

10 Tips to Keep a Family Caregiver from Losing Their Mind

Caring full time for a loved one can be a... Read More

Long Term-Care; 70 Million Americans Will Be Over 65 by 2003

We will all grow old; this is a given. We... Read More

Senior Living: 5 Ways to Help Reduce the Risk of Falling

Every year we hear stories of seniors falling, ending up... Read More

Board and Care Homes ? What Are They?

Board and Care homes (also known as RCFE's - Residential... Read More

Exercise Walking For Seniors: Preventing Foot Problems

Exercise has a very important role in the general health... Read More

Caring for Aging Relatives

It happens somewhat slowly in the beginning, maybe with a... Read More

Stair Lifts - Straight and Curved Rails

There are two types of stairlift. Straight and curved. The... Read More

Stair Lift Buying Guide

There is no doubt that having a stair lift in... Read More

Solitary Confinement -- for Life

Sixty-five year old Arthur Jones served a self-imposed life sentence... Read More

Marketing, Selling, and Serving the Older Adult, Senior Citizens, Family Caregivers

Are your clients pleased by the fine quality service that... Read More