Nursing Homes of the Past
In the past, nursing homes took care of patients in a custodial way, and they really didn’t need a doctor to accomplish this level of care. In those earlier years, the type of patient that went to live in a nursing home was similar to the patient that today goes to an independent or assisted living facility. These were people that needed a certain level of help to handle their day-to-day lives, but not necessarily very much.
What that longstanding manner of nursing home needed most was, like the name implies, nurses. Even today, the most important factor in taking care of patients in a nursing home is the number of nurses on staff and the competency of those nurses. However, there is widespread variation state-by-state when it comes to minimum staffing requirements. While some states require a minimum number of staff hours per resident per day, other states mandate nursing homes provide direct care staff 24/7, without a set number of hours per resident. Eleven states introduced changes to minimum staffing requirements since the onset of COVID-19.
When Medicare set up a payment system to help cover the costs of caring for these individuals, the reimbursement was based, essentially, on a modified room-and-board scenario. That payment system, although modified, remains largely in effect today. Thus, just as renters pay rent once a month, so do patients (or their families or insurance) to keep their loved ones in a nursing home.
– Kenneth L. Scott Jr. DO, CMD
We recognize that specializing in any care setting means not only understanding how to provide excellent care in that setting, but also how to function best within the rules of that setting Dr. Kenneth Scott, DO, CMD will help you to better understand what you and your facility can do to improve.
We believe that understanding the pressure and regulations imposed upon the Long-Term Care environment will allow your facility to truly aid in the production of excellent outcomes.
State Actions to Address Nursing Home Staffing During COVID-19
Numerous studies have found that high staffing levels are associated with higher care quality. Yet, a recent report concluded that “staffing standards in almost every state remain severely low.” In April 2022, the National Academies of Science, Engineering, and Medicine recommended minimum staffing levels, policies to ensure competitive wages and benefits, and improvements to staff training and opportunities for career advancement, among other reforms, as part of its comprehensive report to improve nursing home quality. The Biden Administration has announced plans to propose new federal minimum staffing adequacy regulations in the next year.