SNF deficiencies declining, but staffing still lower than recommended: report

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Staffing levels are still below what some experts recommend, Kaiser reported.
Staffing levels are still below what some experts recommend, Kaiser reported.

The average number of deficiencies per nursing home has dropped in recent years, but staffing levels are still falling short of what some experts recommend, according to a new report from the Kaiser Family Foundation.

Kaiser's “Nursing Facilities, Staffing, Residents and Facility Deficiencies” report, published Tuesday, outlines recent trends in skilled nursing facilities across the United States using data from the On-line Survey, Certification, and Reporting (OSCAR) system and Survey Provider Enhanced Reports.

Among the findings: Data show that deficiencies, for the most part, declined in the 2009-2015 time frame. Between 2009 and 2013 the average number of citations per facility fell from 9.33 to 7.28. That average jumped back up slightly between 2013 and 2015, reaching 8.6 that year.

The percentage of nursing facilities that received no deficiencies followed a similar pattern, rising from 7% in 2011 to 8% in 2013, before dropping again to 7% in 2015. In 2015 more than one-fifth of facilities had a deficiency for actual harm or Immediate Jeopardy, Kaiser found.

The most commonly cited deficiencies were reported in the areas of infection control, accident environment, food sanitation, quality of care and pharmacy consultation.

The report also showed total nursing hours averaged 4.1 hours per resident day in 2015, a slight bump from 3.9 hours in 2009. But despite the increase, the level still falls short of recommendations from some experts, Kaiser noted. That includes a panel of University of California researchers that suggested levels of 4.55 hours per resident day in an article in The Gerontologist.

The Kaiser report also found:

  • Nursing staff training may not be adequate to properly care for high-need residents or those with behavioral conditions, the report's authors said, citing limited training on conditions such as dementia
  • Nursing home capacity has stayed relatively flat, but occupancy rates have declined from 83.7% in 2009 to 81.7% in 2015
  • The percentage of facilities owned by for-profit or chain companies grew slightly between 2009 and 2015, from 67% to 68%

The report's authors said that future research into facility and resident characteristics should focus on “whether and how new requirements are affecting care and outcomes and to identify additional areas of concern for future policy changes.”

Click here to read the full Kaiser report.