Mass. nursing home staffing levels vary a lot

New data indicate staffing levels at Massachusetts nursing homes vary considerably, with 16 percent of the facilities rated “below average” or “much below average.”

The staffing ratings are an indicator of the quality of care but they also may be an indicator of the nursing home’s fiscal stability. Officials from the nursing home industry say many of their facilities are in danger of going out of business because of inadequate funding from the state.

The data, gathered by Medicare but analyzed and compiled by Kaiser Health News, measures staffing levels in a handful of different ways.  The primary measurements are the number of total staff relative to residents and registered nursing staff relative to residents, but the same data are also used to measure staffing levels on the best-staffed days and the worst-staffed days. The most recent data covers the three-month period from January to March 2018.

According to the data, Massachusetts has 395 nursing homes, and 7.4 percent had staffing levels (total staff and registered nurses per residents) that were much below average. Another 8.8 percent were rated below average. Of the remaining facilities, 28 percent were rated average, 16 percent were rated much above average, and the rest were either above average or a combination of average and above average.

Skyline Healthcare announced in April that it was voluntarily shutting down five facilities – three in New Bedford, one in Dighton, and one in Fall River. Of the five, three (Bedford Village in New Bedford, Highland Manor in Fall River, and Dighton Care and Rehabilitation) had staffing levels during the first quarter of 2018 that were rated much below average; the other two were rated average.

Other facilities rated much below average in terms of staffing included Baker-Katz in Haverhill, Bethany in Framingham, Bridgewater Nursing Home, Brighton House in Brighton, Fitchburg Gardens, German Center in Boston, Jesmond in Nahant, Lanessa in Webster, Maplewood in Amesbury, Mattapan Health and Rehabilitation Center in Boston, Odd Fellows in Worcester, Phillips in Lynn, Poet’s Seat in Greenfield, Pope in Weymouth, Riverbend in Natick, Rivercrest in Concord, Seven Hills in Groton, Soldiers Home in Chelsea, Timothy Daniels in Holliston, West Roxbury Health and Rehabilitation in Boston, West Side House in Worcester, and Westborough Healthcare.

The ratings also looked at how staff-to-resident levels fluctuated. On the days when overall staffing levels were the worst, on-duty personnel cared for nearly twice as many residents as they did on weekends, when the staffing levels were the worst.

David Stevenson, an associate professor of health policy at Vanderbilt University School of Medicine, told Kaiser Health News that the volatility in staffing probably means gaps in care. “It’s not like the day-to-day life of nursing home residents and their needs vary substantially on a weekend and a weekday. They need to get dressed, to bathe, and to eat every single day,” he said.

But officials at the American Health Care Association, a trade group, said there are legitimate reasons why staffing levels fall on weekends – there are fewer activities and more family members are visiting patients.




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