For SNF operators, this research underscores that heavy agency use is now visible in PBJ data and directly correlated with lower five-star quality ratings, creating compliance and reputational exposure as CMS advances minimum staffing requirements.
Nursing Homes Increasingly Rely On Staffing Agencies For Direct Care Nursing
By 2022, almost half of all nursing homes used agency staff, accounting for 11 percent of all direct care nursing staff hours. Agency staff were 50–60 percent more expensive per hour than directly employed nursing staff, and nursing homes that used agency staff often had lower five-star ratings. Policy makers need to consider postpandemic changes to the nursing home workforce as part of nursing home reform, as increased reliance on agency staff may reduce the financial resources available to increase nursing staff levels and improve the quality of care.
Bowblis, John R., et al. “Nursing Homes Increasingly Rely on Staffing Agencies for Direct Care Nursing.” Health Affairs, vol. 43, no. 3, Feb. 2024, https://doi.org/10.1377/hlthaff.2023.01101.
Nightmare agency data is a dream-like bounty for the plaintiff’s bar
Late last week, a new study found a fresh way to tell an important pandemic-era storyline: It quantified just how much reliance on agency nursing staff had skyrocketed during the early pandemic and through 2022. By Tuesday (after an extra day off for a holiday weekend, mind you!) a plaintiff’s law firm had pounced on the data, turning it quickly to try to gain a courtroom advantage.
— McKnight’s Long-Term Care News, February 20, 2024
Researchers also examined data from the Nursing Home Compare Archive, which included care ratings for facilities and Medicare Cost Reports, including the labor costs for nursing home employees between 2018 and 2022. Researchers compared quality care ratings among nursing homes and found that those care facilities that used staffing agency workers had lower health inspection ratings and lower average ratings overall.
— AboutLawsuits.com, February 20, 2024
New study reveals depths of agency nurse dependence
The percentage of nursing homes that use agency care workers more than doubled from 2018 to 2022 — from less than 20% to nearly 50%. All told, agency staff went from accounting for 3% of all direct care hours in 2018 to 11% in 2022. “Our study points to a clear problem that CMS has not addressed: Where are we going to find nursing home workers?” Bowblis told McKnight’s Long-Term Care News.
In 2018, agency staff were primarily used to fill short-term gaps in staffing or spikes in occupancy. By 2022, a large portion of the long-term care sector had come to rely on agency work just to meet everyday needs.
— McKnight’s Long-Term Care News, February 16, 2024
States Where Nursing Homes Used the Most Agency Nursing Staff in 2022
Vermont, New York and Maryland led the nation in terms of the share of nursing homes utilizing agency nursing staff in 2022.
By 2022, nearly half of all nursing homes were using agency staff, and 11% of all direct care nursing staff hours were provided by agency workers. The increasing use of agency staff weighed on nursing homes’ bottom lines, with agency staff being 50% to 60% more expensive per hour than directly employed staff, according to the findings.
— Skilled Nursing News, February 14, 2024
