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Staffing inadequacies impair quality of care

Published on November 4th, 2008

The Roanoke News recently had an article about the numerous deficiences and violations found by infrequent inspections of nursing homes. 

At Avante at Roanoke, an unannounced health and fire inspection turned up 34 deficiencies in 2007 — more than four times the national average for for-profit nursing homes. During visits to the facility, inspectors found patients not being bathed because of staff shortages, problems with cleanliness and at least two instances where residents faced immediate harm.

A new national study finds that such problems are not uncommon. Inspectors cited 94 percent of nursing homes last year for federal health and safety standards, the Department of Health and Human Services reported this week.  Nationwide, about 17 percent of nursing homes had deficiencies that caused "actual harm" or put patients in "immediate jeopardy," the report noted, and for-profit homes were more likely to have citations than government-sponsored and nonprofit nursing homes.

Take bed sores, for instance. Last year, Virginia was ranked among the 10 worst states in the nation for high-risk pressure ulcers, she said, noting 2,260 instances.

Virginia’s Medicaid reimbursement rate is so low that facilities lose an average of $7 per day per Medicaid resident, he said. "And yet we have to meet the same 150 federal standards as nursing homes in other states, some of which get close to double the reimbursement."

Avante at Roanoke, a 130-bed facility, had the most violations, with 28 health-inspection infractions and six fire and safety deficiencies. Average daily certified nursing assistant time per patient at Avante was one hour, 40 minutes — less than the region’s top performer by 70 minutes.  Clearly this proves that inadequate staffing impairs the quality of care provided.

The 180-bed Virginia Veterans Care Center had 26 health and three fire and safety violations. "The year before we had three or four total," said Bill Van Thiel, administrator of the Salem facility. "It’s important to remember that any survey is pretty much a one-time snapshot, and there’s a huge range in severity." The existence of bed sores is a much more telling gauge of facility excellence, he added. "Normally we run about three acquired bed sores for 180 patients; that’s way under the national average [of 12.7 percent]. Today, I have none."

 

 

Joe Pioletti
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