It’s no secret that finding and keeping nurses is one of the skilled care sector’s biggest headaches. But it would appear that the folks who regulate this field don’t want to hear it any more.
As Kaiser Health News reported Friday, most facilities that received but one star on the Nursing Home Compare website did so because of a staffing-shortage issue. More to the point, the payroll records at these facilities indicated no registered nurses were on the premises for at least four consecutive days.
If the star reductions don’t send a message, I don’t know what does.
And it’s not like we’re talking about a few outliers here. More than 1,600 facilities were given the one-star treatment in April. That is more than 10% of the entire market.
Any way you slice it, such humiliation is going to have immediate and long-term effects on the field. Short term, it is surely going to harm marketing, recruitment and facility morale at the affected communities. After all, who wants to work in a one-star facility or place a loved one there? Beyond the truly desperate, probably not a whole lot of people.
And as value-based care and partnering with insurers and health systems becomes ever important, a single star rating is not exactly going to make one the belle of the ball.
So what are we to make of this?
The first obvious conclusion is that our friends at the Centers or Medicare & Medicaid Services are not terribly interested in hearing about the sector’s employee recruitment and retention challenges. At this point, it’s clearly a case of not their circus, not their monkeys.
Second, they mean it when they say it’s not a nursing home if there are no nurses. The message behind their April ratings purge is pretty clear: Don’t skimp on registered nurses, or it’ll cost you.
As I have said repeatedly in the past, skilled operators are harnessing data as never before. But so too are regulators.
Case in point: The payroll numbers you are now required to submit create a record. It’s a record that can help or hurt, depending on what its contents reveal. For more than 1,000 facilities, they revealed a staffing gap that could not be explained away as a nurse “calling in sick.” Systemic challenge is closer to the truth, as far as CMS is concerned.
In many ways, what CMS did in April is probably a sign of what’s to come. So if you think that was a painful trip to the woodshed, just wait.
John O’Connor is McKnight’s Editorial Director.