Study Shows That Higher Spending on Nursing Home Staff is Not Tied to Better Staffing Levels
Understanding Nursing Home Spending And Staff Levels In The Context Of Recent Nursing Staff Recommendations
This study examined the proportion of facility revenues spent on nursing staff, as well as nursing staff levels in hours worked and paid per resident day, in 2019.
Nationally, the median proportion of revenues spent on nursing staff was 33.9 percent, and median nursing staff levels were 3.67 hours worked and 4.08 hours paid per resident day. Facilities with higher shares of Medicaid residents spent a larger share of revenues on nursing staff but had lower staffing levels. States varied significantly with respect to median spending on nursing staff (26.8–44.0 percent of revenues) and median nursing staff levels (3.2–5.6 hours worked and 3.6–5.7 hours paid per resident day).
These findings indicate that raising the proportion of revenues spent by nursing homes on nursing staff to a regulated minimum would not guarantee the achievement of adequate nursing staff levels unless it was paired with other regulatory mechanisms.
Bowblis, John R., et al. “Understanding Nursing Home Spending and Staff Levels in the Context of Recent Nursing Staff Recommendations.” Health Affairs, vol. 42, no. 2, Health Affairs (Project Hope), Feb. 2023, pp. 197–206. https://doi.org/10.1377/hlthaff.2022.00692.
Higher Spending on Nursing Home Staff is Not Tied to Better Staffing Levels
Nursing homes with higher shares of Medicaid residents directed more revenue toward workers but had lower staffing levels, indicating that a minimum nursing staff expenditure regulation would not guarantee better staff levels, a Health Affairs study found.
Adequate staffing levels at nursing homes have been associated with better care quality for residents. However, federal regulations do not currently define minimum nursing staff ratios.
A National Academies of Sciences, Engineering, and Medicine report recommended that nursing homes designate a specific share of Medicare and Medicaid payments for direct-care services for residents, including nursing home staff.
“Our findings suggest that any specific threshold for nursing staff expenditures that regulators might consider would have a varying degree of effectiveness in ensuring that any given nursing home was adequately staffed,” researchers wrote.
For a minimum nursing staff expenditure regulation to positively impact staffing, it would have to be paired with a minimum nursing staff requirement. Additionally, any potential regulation should consider the resource constraints that nursing homes face based on their payer mix, reimbursement rates, and workforce.
Bailey, Victoria. “Higher Spending on Nursing Home Staff is Not Tied to Better Staffing Levels.” RevCycle Intelligence, 8 Feb. 2023, https://revcycleintelligence.com/news/higher-spending-on-nursing-home-staff-is-not-tied-to-better-staffing-levelsg-mandate-study.
Spending More Revenue on Labor Not Guaranteed to Achieve ‘Adequate’ Nursing Home Staffing
Pushing nursing homes to allocate more money to increase staffing levels will not necessarily achieve the goals of the proposed minimum staffing standard unless aided by other regulatory interventions, according to a new study.
The study, published in Health Affairs, examined spending and staffing data from more than 12,000 nursing homes and looked at the proportion of revenues these nursing homes spent on nursing staff in 2019.
Facilities with higher shares of Medicaid residents spent a larger share of revenues on nursing staff but had lower staffing levels, the data revealed.
“Any specific threshold for nursing staff expenditures that regulators might consider would have a varying degree of effectiveness in ensuring that any given nursing home was adequately staffed,” researchers wrote.
Grebbin, Shelby. “Spending More Revenue on Labor Not Guaranteed to Achieve ‘Adequate’ Nursing Home Staffing.” Skilled Nursing News, 8 Feb. 2023, skillednursingnews.com/2023/02/more-money-into-nursing-home-staffing-not-guaranteed-to-achieve-adequate-staffing-levels-study.
Addressing Medicaid rates key to minimum staffing mandate: study
Requiring nursing homes to spend a specific share of revenues on direct care alone won’t guarantee that facilities are “adequately” staffed, a new study finds.
Rather, researchers who reviewed spending and staffing data from more than 12,000 nursing homes found that a minimum hourly staffing requirement is more likely to increase direct care.
Still, because of different state Medicaid rates that drive wide variations in staff spending, the Centers for Medicare & Medicaid Services may be hard-pressed to develop a minimum staffing rule that is both effective and widely accepted without providing additional federal funding.
Marselas, Kimberly. “Addressing Medicaid Rates Key to Minimum Staffing Mandate: Study.” McKnight’s Long-Term Care News, 6 Feb. 2023, www.mcknights.com/news/addressing-medicaid-rates-key-to-minimum-staffing-mandate-study.
