Nursing Homes Slash Nurse Staffing After Ownership Changes, Study Reveals
Recent research has shed light on a concerning trend in the nursing home industry: ownership changes are resulting in increased patient numbers but decreased direct care staffing levels. This development raises questions about the quality of care and the priorities of new owners in the long-term care sector.
The Scope of Nursing Home Ownership Changes
Between January 2018 and June 2023, over 2,500 skilled nursing facilities in the United States underwent ownership changes. This significant number of transitions highlights the dynamic nature of the nursing home industry and the potential for widespread impacts on patient care.
More Patients, Fewer Staff
A key finding from the study reveals that after ownership changes, nursing homes admitted an average of 2 more patients per day. However, this increase in patient numbers was not matched by a corresponding increase in staffing levels. In fact, overall staff hours decreased by 0.07 hours per day.
The reduction in staffing was particularly pronounced among nursing staff, with nurse hours declining by 0.09 hours per resident day. This decrease in direct care staff is especially concerning given their critical role in patient care and well-being.
Shifting Priorities in Staffing
While direct care staffing decreased, the study found slight increases in other areas. Non-nursing staff hours saw a modest uptick of 0.02 hours per resident day. More notably, administrator hours increased by 0.5 hours. This shift in staffing priorities raises questions about the focus of new ownership and the potential impact on patient care quality.
The Gradual Nature of Staffing Changes
It's important to note that the staffing reductions did not occur through immediate layoffs or payroll cuts. Instead, the facilities failed to maintain the same nurse-to-patient ratios as patient census increased. This gradual approach to staffing changes may make the reductions less noticeable in the short term but could have significant long-term implications for care quality.
Implications for Care Quality and Industry Oversight
The findings of this study highlight concerns about how ownership transitions in nursing homes may negatively affect staffing levels and potentially impact resident care. The researchers noted that the data indicates a lack of effort to sustain existing staffing levels after ownership changes.
This situation underscores the need for greater transparency and oversight in nursing home ownership changes. The study authors suggest that more information about these transitions could help stakeholders better understand their impacts on staffing and care quality.
The Broader Context of Nursing Home Safety Culture
While this study raises concerns about staffing levels following ownership changes, it's worth noting that other research has found positive aspects of nursing home culture. A separate study reported that most U.S. nursing homes have a culture of safety, despite ongoing staffing concerns. This suggests that the industry is not uniformly struggling with care quality issues, but that specific circumstances, such as ownership changes, may present challenges.
Looking Ahead: Industry Challenges and Potential Solutions
The findings of this study come at a time when the long-term care industry faces numerous challenges. Proposed Medicaid cuts could potentially hurt access to care for assisted living residents, further complicating the landscape for care providers and residents alike.
To address these challenges, industry experts and policymakers may need to consider a range of solutions. These could include:
- Increased transparency requirements for nursing home ownership changes
- Stricter oversight of staffing levels during and after ownership transitions
- Incentives for maintaining or improving staff-to-patient ratios
- Enhanced support and resources for nursing homes undergoing ownership changes
While the nursing home industry continues to evolve, it's crucial that changes in ownership do not come at the expense of patient care quality. The findings of this study serve as a call to action for stakeholders at all levels to ensure that staffing levels and care quality remain top priorities, regardless of ownership status.
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