RN representation holds steady in nursing homes

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The nursing mix at skilled nursing facilities remained virtually unchanged between 2014 and 2016.
The nursing mix at skilled nursing facilities remained virtually unchanged between 2014 and 2016.

Despite an industry-wide push for staffing improvements, skilled nursing facilities did not reduce their reliance on nurse aides between 2014 and 2016, new federal data shows.

Registered nurses made up just 13% of nursing staff at the country's skilled nursing facilities in 2016, according to a segment of the National Study of Long-Term Care Providers conducted by the Centers for Disease Control and Prevention. The new numbers for 2016, the most recent data available, were set to be published online today in the Morbidity and Mortality Weekly Report.

In 2016, nursing aides, as expected, provided the majority of care in all major sectors of long-term care, including nursing homes, residential care communities and adult day programs. The agency definition of aides includes certified nursing assistants, nursing assistants, personal care aides, personal care assistants and medication technicians.

According to the CDC, they accounted for 59% of all staffing hours in nursing homes. Licensed practical or vocational nurses provided 21% and registered nurses 13%. Activities staff members and social workers made up the other 7%.

The same report for 2014 showed aides provided 60% of all nursing home staffing hours, or 1% more, while RNs still accounted for 13%.

The numbers remained virtually stagnant even as regulatory and consumer pressure mounted to increase the RN load. In addition to the existing self-reported staffing component of Nursing Home Compare ratings, the new Payroll-Based Journal system requires facilities to submit their direct care staffing levels information electronically to the Centers for Medicare & Medicaid Services. 

The submissions began in mid-2016, and some had expected the more easily verified data would drive facilities to increase nurse staffing overall. Public files include the total number of hours submitted for jobs in specific nursing categories for every day of the quarter. 

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