Kaiser and NYT analysis: ‘It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years
New York Times and Kaiser Health News Reports
A bombshell joint Kaiser Health News and New York Times report brought nursing home staffing into the spotlight and cast a bright light on payroll-based journal data – in the first widely publicized analysis of PBJ data.
For the first time, nursing homes realized the impact of how third parties interpret the publicly available PBJ reports they’d been submitting for the past two years. And the public perception of the PBJ data led quickly to congressional hearings and updates to the PBJ data submission strategies. In particular, the reporting raised questions on:
- Lower levels of RNs than previously reported
- Weekend nursing levels vs. weekdays
- Downgrades on Five Star ratings for nursing homes
‘Like A Ghost Town’: Erratic Nursing Home Staffing Revealed Through New Records
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.
“‘Like A Ghost Town’: Erratic Nursing Home Staffing Revealed Through New Records.” Kaiser Health News, 13 Jul. 2018, khn.org/news/like-a-ghost-town-erratic-nursing-home-staffing-revealed-through-new-records.
It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years
Medicare has lowered its star ratings for staffing levels in 1 in 11 of the nation’s nursing homes — almost 1,400 of them — because they either had inadequate numbers of registered nurses or failed to provide payroll data that proved they had the required nursing coverage, federal records released last week show.
Medicare only recently began collecting and publishing payroll data on the staffing of nursing homes as required by the Affordable Care Act of 2010, rather than relying as it had before on the nursing homes’ own unverified reports.
The payroll records revealed lower overall staffing levels than homes had disclosed, particularly among registered nurses.
Rau, Jordan. “‘It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years.” The New York Times, 7 July 2018, www.nytimes.com/2018/07/07/health/nursing-homes-staffing-medicare.html.
1,400 Nursing Homes Get Lower Medicare Ratings Because Of Staffing Concerns
Medicare has lowered its star ratings for staffing levels in 1 in 11 of the nation’s nursing homes — almost 1,400 of them — because they either had inadequate numbers of registered nurses or failed to provide payroll data that proved they had the required nursing coverage, federal records released last week show.
Medicare only recently began collecting and publishing payroll data on the staffing of nursing homes as required by the Affordable Care Act of 2010, rather than relying as it had before on the nursing homes’ own unverified reports.
The payroll records revealed lower overall staffing levels than homes had disclosed, particularly among registered nurses.
Rau, Jordan, Elizabeth Lucas. “1,400 Nursing Homes Get Lower Medicare Ratings Because Of Staffing Concerns.” Kaiser Health News, 30 July 2018, khn.org/news/1400-nursing-homes-get-lower-medicare-ratings-because-of-staffing-concerns.
Look-Up: How Nursing Home Staffing Fluctuates Nationwide
This tool shows how Medicare rates overall staffing and registered nurse staffing by facility. It also shows the average number of residents that each nurse and aide must care for on the best- and worst-staffed days. You can sort the facilities by column or hover over them on the interactive maps to view staffing levels.
“Look-Up: How Nursing Home Staffing Fluctuates Nationwide.” Kaiser Health News, 3 May 2019, khn.org/news/look-up-how-nursing-home-staffing-fluctuates-nationwide.
Mining A New Data Set To Pinpoint Critical Staffing Issues In Skilled Nursing Facilities
The Centers for Medicare & Medicaid Services is not known for linguistic playfulness. Nonetheless, at least one person there must have been chuckling when it named its rich new data source for nursing home staffing levels the Payroll-Based Journal, or PBJ.
Like that classic sandwich, the PBJ data set is irresistible. CMS created it to fulfill a requirement of the Affordable Care Act to improve the accuracy of its five-star staffing ratings on Medicare’s Nursing Home Compare website. The data set contains payroll records that nursing homes are required to submit to the government.
Rau, Jordan. “Mining A New Data Set To Pinpoint Critical Staffing Issues In Skilled Nursing Facilities.” Kaiser Health News, 2 Aug. 2018, khn.org/news/mining-a-new-data-set-to-pinpoint-critical-staffing-issues-in-skilled-nursing-facilities.
Report: Poor Staffing Ratings In Houston Nursing Homes
TRYING TO FIND THE RIGHT NURSING HOME facility for an elderly family member is almost always tricky since it’s difficult to tell just from visiting a place whether you’re making the right choice for your loved one.
However, there is data out there, and Kaiser Health News recently mined that data to evaluate nursing homes across the country, including a selection of those in Houston. Their findings? More than half of nursing home facilities—roughly 60 percent—examined in Houston are understaffed.
Their analysis, issued last month, is based on an examination of the data gathered by Payroll-Based Journal (PBJ) when it conducted a study nursing homes across the country from January to March 2018 in a report for Centers for Medicare and Medicaid.
“Report: Poor Staffing Ratings In Houston Nursing Homes.” Houstonia Magazine, 14 Aug. 2018, www.houstoniamag.com/news-and-city-life/2018/08/houston-nursing-homes-poor-ratings.
Staffing totals don’t add up
Nursing homes were placed under a hot spotlight in mid-July after The New York Times ran a lengthy story criticizing fluctuations and apparent understaffing revealed through a new federal data collection process.
The article focused on a Kaiser Health News analysis of Payroll-Based Journal data, which only recently replaced providers’ self-reported figures.
Berklan, James. “Staffing Totals Don’t Add up.” McKnight’s Long-Term Care News, 9 Aug. 2018, www.mcknights.com/news/staffing-totals-dont-add-up
LeadingAge counters after Senator’s staffing demands
A leading industry advocate is firing back, a few days after one U.S. senator demanded changes related to nursing home staffing.
Last week, Sen. Ron Wyden (D-OR) sent a sharply worded letter to the head of the Centers for Medicare & Medicaid Services. In it, the ranking member of the U.S. Senate Committee on Finance demanded answers on how the federal government plans to better hold nursing homes accountable for staffing decisions, in the wake of a critical New York Times story.
LeadingAge countered those remarks on Friday
Stempniak, Marty. “LeadingAge Counters after Senator’s Staffing Demands.” McKnight’s Long-Term Care News, 21 Aug. 2018, www.mcknights.com/news/leadingage-counters-after-senators-staffing-demands
