SNFs Appear to Have Gamed the System When Staffing Was Self-Reported

The federal government has spent the last few years focusing on staffing as a key area of improvement for nursing homes, requiring operators to provide payroll-based evidence of their labor hours and tightening the requirements for achieving the top scores — all based on the assumption that there’s a direct line between staffing and quality.

But a recent study argues that when SNFs had to self-disclose that information, care did not improve even when the facilities reported increased staffing.

When the Centers for Medicare & Medicaid Services (CMS) increased the level of staffing required to maintain star ratings in 2012, facilities that reported an increase in staffing did not see a corresponding decline in bedsore rates.

Specifically, SNFs in competitive markets were more likely to report such staffing boosts without an improvement in care quality, according to an article published in Strategic Management Journal by Amandine Ody-Brasier of Yale University and Amanda Sharkey at the University of Chicago.