It’s common sense that the better staffed a facility is, the better care your loved one will receive. But what does it mean to be adequately staffed?
“A United States Centers for Medicare and Medicaid Services study in 2001 established the importance of having a minimum of 0.75 RN hours per resident day (hprd), 0.55 LVN/LPN hprd, and 2.8 (to 3.0) CNA hprd, for a total of 4.1 nursing hprd to meet the federal quality standards. As part of this study, a simulation model of CNAs established the minimum number of staff necessary to provide five basic aspects of daily care in a facility with different levels of resident acuity. The results found that the minimum threshold for CNA staffing is 2.8 hprd to ensure consistent, timely care to residents.
This recommended minimum threshold level was later confirmed in a 2004 observational study of nursing home staffing and in a reanalysis by Abt Associates in 2011. Across the entire distribution of staffing levels, there is a strong association between higher total staffing levels and better outcomes as defined by lower survey deficiencies and improved resident quality measures from the Minimum Data Set (MDS) (eg, pressure ulcers). Staffing is a better predictor of deficiencies than MDS quality measures, probably because facility-reported MDS quality measures appear to be inflated. Moreover, staffing is a better predictor of hospitalization rates than the MDS quality measures.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833431/
