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Medicare Ratings to Address Chronic Understaffing in Nursing Homes

Many nursing homes are so understaffed that they may be inherently endangering their patients.

It’s become such a chronic problem that Medicare is making changes to its five-star rating program for nursing homes.

The Obama administration announced plans to expand and strengthen Medicare’s Five Star Quality Rating System (also known as Nursing Home Compare).

Staffing levels factor into a nursing home’s overall rating.

However, that data is self-reported, and impossible to verify. Hidden cameras have revealed a rash of nursing home neglect cases in which records were falsified.

Beginning in 2015, Nursing Home Compare will use payroll records to calculate accurate staffing levels.

It’s is one of several proposed changes aimed at improving health outcomes for patients.

Nursing home officials say inadequate staffing is a problem because inadequate government subsidies make it very difficult to attract, compensate, and retain good workers.

Although this change could potentially force some nursing homes to improve the staff-to-patient ratio, there are almost no federal guidelines for adequate staffing. And individual state rules vary: Washington has no law for staff to patient ratio, Oregon mandates an assigned CNA per patient, and “no less than 1 RN hour per resident per week.” California calls for three hours of care per patient, per day.

Updating Medicare’s rating program may help identify the culprits, but it doesn’t solve the problem of the chronic understaffing that too often leads to neglect in nursing homes.

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