In over half of the fifty states, residents are abused or neglected in one out of every five nursing homes. This disturbing rate of improper care fuels families’ worst nightmares. How can they ensure an elderly loved one will be safe when receiving care away from home? One organization is taking strides to answer that question.
Families for Better Care recently released Nursing Home Report Cards, a study of how states rank in terms of providing quality elder care. The organization graded each state’s overall quality of nursing home care based on eight metrics, from the Kaiser Health Foundation, the Centers for Medicare & Medicaid Services (CMS) and state long-term care ombudsman programs. According to the study, an astounding 96% of states struggle to provide adequate staffing, a problem that Families for Better Care claims has a direct and significant impact on quality of care.
In order to achieve high standards, it’s essential that long-term care leaders understand what issues have the biggest impact on the quality of resident care, and staffing levels are a major factor in a long-term care community’s CMS quality rating. In order to achieve a five star quality rating, long-term care leaders have to consider the number of hours of direct care dedicated to each resident, and ensure that they are employing a team of highly-trained staff members. According to the Nursing Home Report Cards study, Alaska has the highest professional nurse hours of all fifty states — one hour and twenty minutes of professional nurse care per patient or resident per day. It also has the highest performance rates when it came to delivery of care.
While the Families for Better Care survey is the first of its kind, its simplicity raises more questions than it may answer. For instance, Alaska’s glowing report is somewhat tarnished once you realize it’s also home to the most expensive facilities in the country. The survey only looked at a handful of quality indicators, as well. Industry specialists are now questioning why facilities in states that are so similar in some areas often differ so greatly in terms of quality care. For instance, Maine received glowing reports, while Indiana was listed among the worst.
LeadingAge Indiana, an advocacy group serving elder care providers, claims the study only considered certified nursing assistants (CNAs) and registered nurses (RNs) in their staffing level measures, while many of their nursing homes also employed licensed practical nurses (LPNs). They say this was the reason their state ranked 48th in direct care hours and the reason one of four homes was cited with severe care deficiencies. LeadingAge was also quick to point out that the report was financed, in part, by a legal group specializing in malpractice suits.
That isn’t to say that some facilities don’t provide higher quality care than others, or that the study contains completely flawed data. Overall, it seems clear that the results support what industry experts have known for quite a while — it takes an adequately staffed team of highly qualified direct care workers to ensure nursing home residents receive the highest levels or care, and this should improve a facility’s quality rating.
When it comes to recruiting in the competitive field of long-term care to maintain the right staffing levels, this can be challenging because there is often a high volume of unqualified applicants. Heritage Community of Kalamazoo said that they often process up to 4,300 applications a month. To streamline the recruitment process and reduce time-to fill in order to maintain adequate staffing levels, communities like Heritage have implemented applicant tracking software. Using applicant tracking software, hiring managers and recruiters can set time-to-fill goals that are easier to achieve thanks to features like an online application that doesn’t allow candidates without the minimum requirements to complete their application. Improving the efficiency of the recruitment process helps long-term care organizations maintain adequate staffing ratios to meet the CMS quality rating requirements, allowing them to provide high quality care to their residents.
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