Nurse Staffing In Nursing Facilities

Source: Toby S. Edelman, Center for Medicare Advocacy, June 18, 2014

…In the absence of strong federal standards, states, over the years, have used a variety of approaches, often in combination, to strengthen the nursing workforce in nursing facilities. Some states have focused directly on improving staffing levels by mandating explicit staffing ratios. Other states have created financial incentives to facilities to increase staffing, using wage pass-throughs, or increases in Medicaid rates, or pay-for-performance bonuses. Public reporting of staffing information uses a market-based approach. A fourth approach addresses workforce issues by proposing more and better training and calling for career ladders that would enable aides to improve their skills and advance into professional positions.

With funding from a CyPres award in Lavender v. Skilled Healthcare LLC (Calif. Super. Ct., Humboldt Co.), Case No. DR060264, the Center for Medicare Advocacy is looking at the broad variety of state approaches and their effectiveness, or lack of effectiveness, in achieving improved staffing levels and competencies. The project will issue a series of short papers on the state approaches, with a bibliography for each. It will also interview national experts in the field and report on their observations and recommendations on the most and least promising approaches to improving nurse staffing. …