The National Consumer Voice for Quality Long-Term Care (Consumer Voice) is calling for minimum nursing home staffing standards in response to a recently released Department of Health and Human Services Office of Inspector General (OIG) report, “Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries.” The OIG investigation found that one third of skilled nursing home residents are being harmed, and in some cases, even dying, as a result of “adverse or temporary harm events” – instances where harm results due to the care provided – or not provided – by the facility. Examples of such events include excessive bleeding due to medication, falls, infections, pressure ulcers, blood clots, acute kidney injury and worsening of preexisting conditions due to lack of care.
In addition to a high level of harm, the OIG found that almost 60% of these events were preventable and resulted from substandard care, inadequate resident monitoring and failure or delay of necessary care. According to Robyn Grant, Director of Public Policy and Advocacy for the Consumer Voice, providing care, treatment and monitoring of residents are all nursing duties. “Poor and often tragic outcomes result when there are insufficient numbers of registered nurses (RNs), licensed practical nurses (LPNs) and certified nursing assistants (CNAs),” Grant said. Low staffing levels are the single most important contributor to poor quality of nursing home care in the United States.1Despite these well-established findings, there is no minimum number of nurse and nursing assistant hours per resident/day mandated by the federal government.
Grant stated that the public should be appalled and outraged that frail elders and persons with disabilities are suffering or dying from preventable events and that tax dollars are paying for treatment needed afterwards. “While you cannot put a price on human suffering, you can certainly put one on hospitalizations,” Grant noted. The OIG estimated that hospital treatment for the harm caused in skilled nursing facilities cost Medicare $208 million in August 2011, amounting to $2.8 billion for all of FY 2011.
To reduce the incidence of these events, the OIG recommends helping nursing home staff to better recognize harm and instructing nursing home inspectors to review what nursing homes are doing to identify and reduce resident harm. “While additional guidance to surveyors could be helpful and educated staff is essential, we must have stronger, more effective enforcement of the federal regulations to bring about change and enough nurses and nursing assistants to carry out good care practices,” said Grant.
The Consumer Voice calls on federal legislators to pass a law requiring minimum staffing standards in nursing homes and to use the wasted $2.8 billion to pay for additional nursing staff so that residents are cared for instead of harmed.
To read the OIG report, click here.
Contact: Robyn Grant (202) 332-2275 x205
1 Charlene Harrington, Ph.D; University of California-San Francisco.