OIG: Pandemic Data Shows Major Changes Needed in Nursing Home Staffing, Surveys, Infection Control

Jan 30, 2023 | Nursing HPRD & Turnover, Research Studies of PBJ Data

PBJ research report and related news:

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More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic

This is the second report in the series and builds on the first OIG report by focusing on nursing homes themselves. It looks at the extent to which they had residents who were diagnosed with COVID-19 or likely COVID-19, and the characteristics of nursing homes with extremely high infection rates. The third report will feature specific challenges nursing homes faced and the strategies they used to deal with them.

For-profit nursing homes made up a disproportionate percentage of the nursing homes with extremely high infection rates during both surges. Other characteristics varied by surge. For example, urban nursing homes were more likely to have extremely high infection rates during the first surge, but rural nursing homes were more likely to have extremely high rates during the second surge.

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Office of the Inspector General. “More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic; Better Protections Are Needed for Future Emergencies.” Department of Health and Human Services, 19 Jan. 2023, oig.hhs.gov/oei/reports/OEI-02-20-00491.asp, January 2023.

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OIG: Pandemic Data Shows Major Changes Needed in Nursing Home Staffing, Surveys, Infection Control

A federal watchdog agency is calling for “significant changes” to nursing home operations and oversight in light of new data on Covid-19 infection rates.

The Department of Health and Human Services Office of Inspector General (OIG) calls on the Centers for Medicare & Medicaid Services (CMS) to take action in a report issued Thursday.

Recommendations made by the HHS Office of the Inspector General (OIG) build on previous probes into the skilled nursing industry and include re-examining and revising nursing staff requirements.

The recommendation acknowledges an initiative already underway with the Centers for Medicare & Medicaid Services (CMS), namely, a staffing mandate proposal and supporting study due to be published this year.

Part two of this first recommendation – re-evaluating staffing data collection – should better align with staffing requirements outlined in the mandate proposal, OIG added.

“For example, amending staffing data to include a timestamp would better allow CMS to determine whether nursing homes have provided around-the-clock nursing services,” OIG said in its report. “This would assist CMS in monitoring compliance with staffing requirements, as well as ensure quality data for future analyses.”

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Stulick, Amy. “OIG: Pandemic Data Shows Major Changes Needed in Nursing Home Staffing, Surveys, Infection Control.” Skilled Nursing News, 19 Jan. 2023, skillednursingnews.com/2023/01/oig-pandemic-data-shows-major-changes-needed-in-nursing-home-staffing-surveys-infection-control.

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OIG: Over 1,000 Nursing Homes Reached 75 Percent Infection Rates in COVID-19 Pandemic’s First Year

More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic; Better Protections Are Needed for Future Emergencies (OEI-02-20-00491)Nursing homes had a surge of COVID-19…

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AAPACN. “OIG: Over 1,000 Nursing Homes Reached 75 Percent Infection Rates in COVID-19 Pandemic’S First Year.AAPACN, Jan. 2023, www.aapacn.org/news/oig-over-1000-nursing-homes-reached-75-percent-infection-rates-in-covid-19-pandemics-first-year.

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Research shows COVID-19 vaccination mandates don’t negatively affect nursing home staffing

State COVID-19 vaccination mandates increased vaccinations among direct caregivers without negatively affecting staffing levels, according to the results of a study published Friday in JAMA Health Forum.

The researchers studied vaccination rates and staffing shortages that were reported via the Center for Disease Control and Prevention’s National Healthcare Safety Network from June 6, 2021, through Nov. 14, 2021.

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Nursing home staff turnover up 25 percent from last year

The national nursing home staff turnover rate for all employees is up 25% from last year. That’s according to findings included in the 45th annual Nursing Home Salary & Benefits Report released Thursday by Hospital & Healthcare Compensation Service.

The average national turnover rate across executive-level positions and those in dining services, environmental services, marketing and therapy was 29.17%, according to the report. The national average turnover among registered nurses, licensed practical nurses and certified nursing assistants was 38.68%.

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Study confirms lower turnover linked to higher quality of care

Nursing home providers should consider implementing innovative strategies for retaining workers after a new study found that low staff turnover was consistently associated with higher quality of care, researchers said.

“While these actions are challenging — especially given that nursing homes are navigating the COVID-19 pandemic, they are clearly warranted if we seek an improved quality of care for nursing home residents,” Qing Zheng, Ph.D., lead author and health economist at research firm Abt Associates

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Study Shows Weekend and Daily Variation in Nursing Home Staffing Led to Poorer Clinical Quality

Daily variation in nursing home staffing was associated with poorer clinical quality in Medicare and Medicaid-certified nursing homes, suggesting that reporting staffing variation could help provide new quality improvement information, according to a study published in JAMA Network Open.

Typically, nursing home quality regulations include minimum staffing standards to ensure that facilities provide residents with quality care. Meeting the average staffing level has been associated with better performance on process quality measures, on-site survey scores, and resident outcome measures.

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State of Skilled Nursing Facilities Today, Planning for the Future

What are the four key findings and what can nursing home leaders do today to put themselves on the path of recovery? Some of the answers include strategic planning, operational assessments, and self-evaluation.

Nursing facilities should work now to determine changes that can be made – clinically, operationally, and financially – for better or more strategic outcomes.

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Appropriate Staffing Standards in Post-Acute and Long-Term Care

A push to mandate staffing levels at both state and federal levels persists after several decades.

Skilled Nursing Facilities (SNFs) and long-term care (LTC) facilities (also referred to as nursing homes or nursing facilities) are no longer just for aging geriatric residents. Acuity level has increased and entering residents are younger, and/or with far more medically and socially complex needs (including more management of behaviors, tracheostomies, complex wound care, drains/tubes, life vests, and IV medications). In addition, experiences during the COVID-19 pandemic confirmed the importance of having sufficient staffing based on facility need and of hiring high-quality, well-trained staff.

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