For roughly half the properties, the downgrades lowered their general star rankings, that are the measures displayed most prominently on the location. However a few of the properties noticed their general rankings keep the identical and even rise, buoyed by their scores on different high quality measures. Seventy-nine are nonetheless rated with a coveted 5 stars.
Whereas the Kaiser Well being Information evaluation discovered considerably decrease common staffing of nurses and aides at for-profit amenities than at nonprofits and government-owned properties, the variety of downgraded nursing properties was roughly proportionally divided among the many three classes, indicating an industrywide concern with staffing by registered nurses particularly.
Medicare concedes that as a result of the payroll system is geared towards reporting hourly work, salaried workers might not at all times be mirrored appropriately, particularly in the event that they had been working time beyond regulation. However Medicare had warned the nursing properties in April that the downgrades could be coming if amenities continued to point out no registered nurses on obligation. The company famous it has been making ready nursing properties since 2015 for the brand new payroll system.
“We’ve simply begun to leverage this new info to strengthen transparency and enforcement with the objectives of improved affected person security and well being outcomes,” the Facilities for Medicare & Medicaid Providers stated in an announcement.
The payroll knowledge, analyzed by Kaiser Well being Information, confirmed that for-profit nursing properties averaged 16 p.c fewer workers than did nonprofits, even after accounting for variations within the wants of residents. The largest distinction was within the variety of registered nurses: On the common nonprofit, there was one RN for each 28 residents, however on the common for-profit, there was just one RN for each 43 residents. Researchers have repeatedly discovered decrease staffing in for-profit amenities, which make up 70 p.c of the trade.
The info additionally revealed that nursing properties have massive fluctuations in staffing. The typical nursing dwelling had one licensed nurse caring for as few as 17 residents or as many as 33, relying on the day. On the best-staffed days, every licensed nursing assistant or different aide cared for 9 residents, however on the worst-staffed days, every aide was liable for 16 residents.
Weekend staffing was significantly sparse. On weekends on common, there have been 11 p.c fewer nurses offering direct care and eight p.c fewer aides.