80% of nursing homes report misleadingly high staffing levels, Center for Public Integrity claims

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More than 80% of skilled nursing facilities might have inflated registered nurse staffing levels on the Nursing Home Compare website, according to the Center for Public Integrity, a investigative journalism organization.*

For a quarter of nursing homes, the self-reported registered nurse staffing levels on Nursing Home Compare were at least double what they were based on a Center for Public Integrity analysis of Medicare cost reports.

The Centers for Medicare & Medicaid Services has stated that Medicaid cost reports — similar to Medicare reports — contain more reliable information than Nursing Home Compare, reporter Jeff Kelly Lowenstein noted. However, the cost reports are not easily understood by everyday consumers, who use Nursing Home Compare to evaluate facilities.

The staffing issue has been a hot topic, following an August New York Times article that claimed nursing homes “staff up” prior to surveys to boost their ratings. That led to an outcry from lawmakers, who pointed out that the Affordable Care Act calls for verification of staffing data.

Prominent long-term care associations challenged some of the New York Times reporting but supported verification of data. The recently passed IMPACT Act calls for electronic submission of staffing data, officials from the American Health Care Association/National Center for Assisted Living and LeadingAge pointed out.

"We are optimistic that the new IMPACT law will go a long way in addressing these discrepancies so we have an even better system to present meaningful data to patients and families. That's the end goal,” AHCA/NCAL Senior Vice President of Public Affairs Greg Crist said in an email to McKnight's.

LeadingAge has “long expressed concerns over how staffing levels are reported” and supported the IMPACT provisions, stated Cheryl Phillips, M.D., senior vice president of advocacy and public policy.

“We believe that staffing is the platform to quality care,” Phillips added in her comment to McKnight's. “Furthermore, multiple studies ... have recognized that non-profits consistently have higher staffing ratios than for-profit nursing home providers.”

Click here to access the Center for Public Integrity article on its investigation. Click here for an accompanying CPI article on the findings.

*Editor's Note: The original version of this article has been updated to clarify that this figure applies to registered nurse, not total daily, staffing levels.