Nursing homes that serve mostly minority residents tend to have drastically lower registered nurse staffing levels than other facilities, according to the Center for Public Integrity, an investigative journalism organization.
In facilities where the residents are mostly non-Latino whites, daily average RN staffing levels are roughly 60% higher than in majority-Latino nursing homes and 34% higher than in facilities with mostly black residents, the Center for Public Integrity determined. Higher staffing levels have been linked to better care quality.
The findings are based on Medicare cost reports, which the government has indicated might contain more accurate staffing information than the Nursing Home Compare website. Critics have charged that some facilities inflate the self-reported numbers used for the consumer website. The cost reports suggest that RN staffing is indeed below levels indicated on Compare, the Center for Public Integrity’s Jeff Kelly Lowenstein reported last week.
Variables such as rural vs. urban location, percentage of Medicaid reimbursements and residents’ health status could not explain the racial disparities in RN staffing, Lowenstein wrote in an article published Monday. It was the third and final part in CPI’s nursing home series.
A number of factors could be contributing, such as the fact that racial minorities might be living in neighborhoods where registered nurse recruiting is more difficult, Lowenstein noted. Richard Mollot, executive director of consumer advocacy group the Long Term Care Community Coalition, said his “feeling has long been” that some providers skimp on services in minority communities, because they perceive that expectations are lower.
This type of practice potentially would be illegal, but a Department of Health and Human Services official “could not say” whether the CPI investigation had uncovered civil rights violations, Lowenstein reported.
Long-term care providers nationwide have been improving staffing ratios, David Gifford, M.D., told Lowenstein. This is contributing to a “continually improving” quality of care, said Gifford, who is senior vice president of quality and regulatory affairs at the American Health Care Association/National Center for Assisted Living.
Recently passed legislation has mandated that staffing information come directly from payroll systems. The new data collection process is slated to begin on a limited, voluntary basis next year, Centers for Medicare & Medicaid Services officials said last week.
