Keypoints
STAFFING IN NURSING HOMES
¬ There were 262 licensed nursing facilities with a total of 32,080 beds in Connecticut as of March 31, 2000.
¬ Under federal law, nursing homes must "provide nursing and related services and specialized rehabilitative services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident."
¬ No minimum nursing-staff-to-resident ratios are mandated under federal law or regulations. Federal law requires all certified nursing facilities have a licensed nurse on duty 24 hours a day; a registered nurse on duty at least eight hours a day, seven days a week, and an RN director of nursing.
¬ Connecticut's Public Health Code establishes specific nurse and total direct care staff-to-resident ratios.
¬ The current minimum total nursing staff hours per resident in a chronic convalescent nursing home bed is 1.9 hours per day - an average of less than five minutes of care per resident, per hour.
¬ Based on an analysis of Medicaid cost report data (submitted annually by facilities), all of Connecticut's nursing facilities exceed the minimum nursing-staff-to-resident- day ratios. The majority of homes provide nursing staff between one-and-one-half- to two-and-one-half times the threshold.
¬ Information on actual nursing-staff-to-resident levels per shift is not readily available because there are no standardized data collected on a routine basis to monitor nursing staff levels in nursing homes.
¬ The Department of Public Health has drafted proposed regulations that would increase the total nursing staff hours per resident day from 1.9 hours to 2.48 hours per day.
¬ Connecticut's average nursing-staff-hours-to-resident-day (3.16) is the second lowest in New England. Maine had the highest average staffing ratio at 3.86.
¬ A recently released study by HCFA found a strong relationship between the number of nursing staff and the quality of care provided in nursing facilities. Preliminary findings suggest 2.75 may be the minimum staffing level that reduces the likelihood of quality-of-care problems and 3.00 is a "preferred minimum" ratio, which would contribute to improvements in quality of care.
¬ Key barriers to increasing nursing staff are cost and shortage of trained personnel in the labor market.