Impact of Low Staffing on Nursing Home Performance

As the American population ages, nursing homes are expected to experience a surge in demand. However, the American Health Care Association’s 2024 State of the Sector report indicates that there are insufficient skilled nursing home staff to meet the demand.

Doctor talking with her elder patient
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Among the most alarming statistics is that 99 percent of nursing homes have open positions, including openings for registered nurses. Facilities are having difficulty recruiting and retaining staff, and not even increased wages, annual bonuses, and other incentives are making a measurable difference.

These staffing shortages can have a significant impact on the care that’s offered in nursing homes.

1. Failure to Meet Minimum Staffing Hours

According to the Centers for Medicare & Medicaid Services (CMS), each nursing home resident should receive 3.48 hours of care daily. This includes 0.55 hours by a registered nurse and 2.45 by a nurses’ aide. Any qualified nursing home staff member can complete the remaining care hours.

If a nursing home is understaffed, they may be unable to offer their patients the minimum care hours. This care gap can lead to the residents feeling isolated. They may lack human connection and develop feelings of anxiety and depression as a result.

2. Increased Medical Errors

Larger workloads can lead to increased medical errors. These behaviors could include incorrect medication dosages, missing medication, missed doctor’s appointments, and the wrong treatment. If a resident needs to be transferred to a hospital for additional care, nursing home staff could send incorrect records and cause a delay in care.

These medical errors can have serious consequences and even lead to a patient’s death. A simple mistake in the healthcare field can be devastating, and they’re more likely to happen when staff members are overworked.

3. Increased Cases of Abuse and Neglect

Delayed care can be a form of nursing home abuse. Patients are unable to receive prompt care. It may take nursing home staff hours to respond to a call button. The patient may try to move themselves, accidentally fall, and injure themselves. These scenarios can cause the resident harm and may even lead to severe complications, including death.

Additionally, residents can be left unattended for long periods. If so, the pressure on the body mixed with surface friction can cause bedsores. These only occur if a person is not moved or repositioned regularly. The deeper the wound, the longer they have remained sedentary.

You can identify if a facility has any active citations or penalties against them for neglect on the Medicare website. They provide an overview of a facility’s rating on their website. Review nursing homes like Ocala Oaks Rehabilitation Center to see if they’re violating nursing home regulations.

The website provides a detailed analysis of a facility’s staffing ratios, including the number of care hours its residents receive and how that compares to federal and state averages.

4. Increased Patient Dissatisfaction

Nursing home residents share their opinions annually as part of the CMS survey. There are questions about the care they receive, the food, the facilities, and the staff. Residents can share their feedback if they feel the staff mistreats them, doesn’t spend enough time with them, or lacks staff.

These results can cause nursing homes to be investigated and placed on action plans. If the nursing home does not address the understaffing, they can even be forced to close.

5. High Turnover Rates

High turnover at a nursing home can also impact the quality of care received as new staff members constantly face a learning curve. When they become familiar with the nursing home procedures and policies, they often quit, causing the process to start all over. This process is extremely costly and cumbersome for nursing homes.

Additionally, high turnover can cause stress for patients. They don’t trust their caregivers because they turn over so quickly. Building a rapport with them is a waste of energy. The patient feels the caregiver doesn’t understand their care requirements and they’re constantly re-explaining their needs to new people.

These interactions can be highly disengaged to residents and affect their physical and mental well-being.

6. Operating Disruptions

If nursing homes don’t have enough staff to support their current needs, they may turn away prospective patients. If these challenges persist, this can impact the facility’s operating margins and negatively affect its continued financial health.

Additionally, there may be disruptions in standard operating procedures. Clerical tasks may take a backseat to meet immediate care. This can cause a delay in record processing, which can negatively impact a patient’s health. For example, patients may be given multiple prescriptions by different doctors without knowing it because they weren’t correctly charted.

Nursing homes must provide up-to-date records for all their patients, but they may be unable to do so based on staffing shortages.

Conclusion

Staffing shortages can impact a nursing home’s performance, leading to severe consequences. Review a nursing home’s staffing levels on the CMS website to help you make an informed decision about nursing care for your loved one.