Kentucky has a habit of being in the top ten. Top ten best college basketball programs. Top ten best “foodie” places. Unfortunately, we also rank in the top ten—or bottom ten—in nursing home understaffing. According to a 2018 national study by the Kaiser Family Foundation, over 40% of Kentucky nursing homes have only one star for staffing levels in the industry-standard Five Star rating system for nursing homes, placing the Commonwealth near the bottom. This follows a report from a patient advocacy group giving Kentucky a “D” in the quality of its nursing homes.
Nursing homes that do not have enough RNs, LPNs, and CNAs to provide patient care frequently see more falls, poor hygiene, pressure sores, missed medications, missed meals, and even deaths. Over three decades ago, study after study about understaffing in nursing homes, and resulting substandard care of patients, led Congress to act, passing legislation requiring nursing homes to have “sufficient staffing to meet the nursing needs of each of its patients.”
The Center for Medicare and Medicaid Services (CMS) has since created the Five-Star rating system, with one of the categories based on staffing levels, using a chart of RN, LPN, and CNA hours of care per patient to determine whether a nursing home met its expected staffing level. While a lower star rating may lead customers to choose another nursing home, a low star rating by itself will not necessarily lead to a nursing home closing.
In addition to the federal star rating system and requirement that nursing homes have “sufficient” staffing, many states have specific statutes and regulations for how many hours per patient a nursing home must have nursing staff, with higher hours for patients needing specialized, additional care. However, Kentucky does not presently have any statute or regulation requiring a certain number of nurse hours per patient. Additionally, CMS’s star rating system allows nursing homes to self-report their staffing, encouraging nursing homes to “game the system” and improve their star rating by misreporting their staffing levels.
In the past year, there have been not one, but two efforts in Frankfort—from both sides of the political aisle—to have Kentucky adopt a minimum staffing requirement for its nursing homes. CMS has also changed how nursing homes report their staffing data, tying it in to payroll reports, which will hopefully lead to more accurate staffing reports. These efforts are badly needed as Kentucky’s nursing homes continue to rank among the worst in the nation.
If you or a loved were the victim of abuse, neglect, or suffered an injury at a nursing home, especially at a facility you believe was understaffed, please contact us at the Poppe Law Firm.