Most Nursing Communities Overstated Staffing for Years, Analysis Finds

A federal data analysis by Kaiser Health News found that most U.S. nursing communities had fewer nurses and caregivers than they had reported to the government for years, according to the New York Times . The analyzed data included daily payroll records that Medicare only recently began collecting and publishing from more than 14,000 nursing communities, as required by the Affordable Care Act. Previously, Medicare gauged each community's staffing levels based on the communities' own unverified reports. The agency is now using the new data to assess staffing, but revamped five-star ratings still conceal high fluctuation of day-to-day staff. Almost 1.4 million people are cared for in skilled nursing communities in the United States. Medicare does not establish minimum resident-to-staff ratio, but it does mandate the presence of a registered nurse for eight hours daily and a licensed nurse at all times. Payroll records also indicated that even positively-rated communities were short of nurses and aides on certain days. In April, the government began using daily payroll reports to estimate average staffing ratings, while the old method depended on communities to report staffing for the two weeks prior to an inspection. The communities sometimes anticipated the coming inspection and could staff up before it. The new records found that on at least one day during the last three months of 2017, 25 percent of communities reported no registered nurses at work.