New data shows nursing home staffing levels are often overstated

New payroll data has shown that nursing homes have long overstated their staffing levels to Medicaid.

Many people looking for a nursing home either for themselves or for a loved one will often rely heavily on the Centers for Medicaid and Medicare Service's (CMS) star-rating system. However, a recent New York Times report is calling into question how reliable a measure the star-rating system is when determining a nursing home's quality of care. The report showed that most nursing homes across the country have exaggerated their staffing levels to the CMS for years in a bid to boost their star ratings.

Staffing and star ratings

CMS's five-star rating system is based on a number of factors, one of the most important of which is staffing levels. Nursing homes that have lower ratios of residents to nurses or aides generally score higher on the star system. However, until last year nursing homes were allowed to simply self-report their staffing levels to CMS. Because such self-reports were largely unverifiable, the system was prone to abuse.

When the Affordable Care Act was passed in 2010, however, it mandated that nursing homes begin providing payroll data instead of self-reported data. Because payroll data can be verified, it is more likely to reflect actual staffing levels at nursing homes.

The New York Times report found that of the 14,000 nursing homes where it was possible to compared payroll data to self-reported data, about seven out of ten had previously exaggerated their staffing levels under the self-reported system. On average, staffing levels were 12 percent lower using payroll data than self-reported data.

Finding safe nursing homes

Frustratingly, however, despite the fact that most nursing homes have exaggerated their staffing levels, very few of those homes will see their star ratings fall as a result. That's because the star system is graded on a bell curve, with homes ranked in relation to one another. Since the majority of nursing homes exaggerated their staffing levels anyway, most nursing homes will still find themselves in much the same position in relation to one another as before and thus their star-rating will remain the same.

That fact has led to calls for the CMS to overhaul how it grades nursing homes. Staff shortages are a major cause of nursing home abuse and neglect. With too few nurses and aides on duty, residents are less likely to be moved or cared for adequately, thus increasing the risk of bedsores, infections, dehydration, and malnutrition. These concerns are especially high in New Mexico, which, according to the Albuquerque Journal, already has the highest number of serious deficiencies per nursing home in the country.

Nursing home negligence

Nursing home residents are, sadly, especially vulnerable to abuse and neglect. Anybody who is worried that their loved one may have been subjected to such abuse or neglect should get in touch with a medical malpractice attorney today. An experienced attorney can help build a case for abuse victims and assist them with pursuing compensation they may be eligible for.