Low staffing is a root cause of many injuries in nursing homes. Kaiser Health News senior correspondent Jordan Rau explains how he connected the dots between manpower and risk at facilities nationwide, using a federa tool known as the Payroll-Based Journal.
Medicare said those homes either lacked a registered nurse for “a high number of days” over three months, provided data the government couldn’t verify or didn’t supply their payroll data at all.
Daily nursing home payroll records just released by the federal government show the number of nurses and aides dips far below average on some days and consistently plummets on weekends. A new California law increases minimum staffing standards at nursing homes, but critics say it doesn’t go far enough.
Despite a decision by the Trump administration to ask a court to nullify the portion of the health law guaranteeing coverage to the sick, the Kaiser Family Foundation poll finds most people want insurers to be required to offer coverage and not charge more.
Nationally, one in five Medicare patients who leave the hospital for a nursing home end up back in the hospital. In California, one-fifth of the more than 1,200 nursing homes send at least 24 percent of their Medicare patients back to the hospital. To discourage this trend, the Centers for Medicare & Medicaid Services will soon give bonuses and penalties to facilities based on their rehospitalization rates.
The economy and jobs tend to eclipse health care as the top voter concern in competitive congressional and gubernatorial races.
Increasingly, owners of nursing homes outsource services to companies in which they also have financial interest or control. That allows the nursing homes to claim to be in the red while owners reap hidden profits.
In California, Medicare penalized 30 percent of the hospitals it assessed. Seven states saw a third or more of their hospitals punished under the federal heath law’s campaign against hospital-acquired conditions.
Medicare is discouraging regional offices from levying fines for “one-time mistakes” or from using daily fines that seek to put pressure on nursing homes to make changes.
In California, 88 hospitals were penalized, including Stanford Health Care’s hospitals in Stanford and Pleasanton, the University of California-San Francisco (UCSF) Medical Center. Each hospital will have its payments reduced by 1 percent for the year.