The implementation of a federal minimum staffing standard for nursing homes would not be economically feasible for providers under current reimbursement rates, newly released research shows.
U.S. facilities would have to spend nearly an additional $5 billion per year in order to meet the requirement, according to the new findings in Innovation of Aging. That would require greater contributions by federal and state governments, an analyst found.
“Without clear guidance on the staffing level needed to be sufficiently staffed, most [nursing homes] are subject to a community standard of care, which some have argued could be associated with suboptimal staffing levels,” wrote study author John R. Bowblis, Ph.D. Bowblis is an economic professor and research fellow of the Scripps Gerontology Center at Miami University (OH).
“Implementing an acuity-based benchmark could result in improved staffing levels, but also comes with significant economic costs,” he added.
Bowblis used archived Nursing Home Compare staffing data and Medicare cost reports for the investigation and compared the data to a previously developed employee benchmark that accounts for average nursing time per resident and patient acuity. He then calculated each facility’s actual staffing level and what it should be based on the benchmark.
He found 60% of nursing homes’ total staffing levels were below their benchmarks, with 80.2% of facilities not meeting registered nursing levels and 54.4% not meeting levels for certified nursing assistants.
He also found that 59.1% of nursing homes would incur additional operating expenses in order to staff to the benchmark.
The nationwide increase in operating expenses for nursing homes was estimated to be approximately $4.9 billion per year. The additional cost would mean each nursing home would have to pay $538,090 to meet its benchmark.
“Without being offset by additional revenue, implementing the STM [staff time measurement] benchmark would cause nearly three-quarters of the [nursing home] industry to lose money providing services to residents and could result in the majority of NHs declaring bankruptcy or closing,” Bowblis wrote.
He added the findings mean the political feasibility of implementing a benchmark depends on the willingness of federal and state lawmakers to increase taxpayer spending on nursing home care.
“This may be politically and economically impossible in states that have the largest gap between actual and STM benchmark staffing levels without federal assistance,” he concluded.
