The Illinois Trial Lawyers newsletter today included a stoary that won’t shock most lawyers handling nursing home cases – most nursing homes aren’t adequately staffed. While Medicare doesn’t set a minimum staff to patient ratio, it does require that a registered nurse be on the premises at least eight hours a day and a licensed nurse be present at all times.

Kaiser Health News analyzed daily payroll records that Medicare had assembled from over 14,000 nursing home nationewide. Some of the jarring findings included:

• On at least one day during the last three months of 2017, 25% of the facilities reported that not a single registered nurse was on the premises;
• Even highly rated nursing homes sometimes had only 1 aide caring for 8 patients;
• Some nursing homes reported instances where 1 aide was caring for 18 patients.

The Center for Medicare and Medicaid Services[CMS] is alarmed and taking steps to address the fluctuations in nursing staffs. The ramifications of missing staff have real life ramifications. When nurses and aides are absent, residents can’t get the help the need to go to the bathroom. So those residents try to do so without necessary help and fall. Or the bedbound patient doesn’t get the necessary repositioning he needs. So bedsores develop. Other patients go without vital medications. David Stevenson, an Associate Professor of Health Policy at Vanderbilt University School of Medicine noted that staff “volatility means gaps in care.” In other words, when nursing homes are understaffed, residents get hurt.

The article mentioned Stan Hugo, a retired math teacher, whose wife Donna lives at Ithaca, New York nursing home facility. In 2017 he and other residents and family members became so dissatisfied with the care their loved ones received they formed a council to monitor operations. Medicare regulations require that nursing home administrators listen to the grievances and recommendations made by such councils.

Hugo visits his wife every day. And he counts the nursing assistants he sees attending to patients. On at least on occasion, he has seen 2 nursing aides trying to cover 40 patients.

This is a long standing problem that results in countless injuries and deaths. Now that the data is out there, perhaps CMS can craft a meaningful solution.