What to Do If Your Nursing Home Has a Huge Staff Shortage

Female nurse helping elderly woman stand up

New data is out that shows the fewer nurses are on hand, the more senior care facilities get failing marks from Medicare. 

According to the April edition of its Nursing Home Compare index, released by Medicare & Medicare Services, 1,638 U.S. nursing homes have earned a lowest-ranked “one star” ranking – mostly because their weren’t enough nurses on hand to care for senior residents.

Additionally, data from Kaiser Health News cited over 2,600 U.S. senior care facilities (of a total of 15,500 US nursing homes) did not register a visit from a registered nurse for a period of four or more days

“Yes, the nursing shortage is real and is getting worse,” says Cecilia Summers, a registered nurse for 44 years who has worked in multiple nursing home facilities as a nurse and as a manager.

When Summers was managing nursing homes, she says it was “normal” for her to be in charge of 40-plus patients plus her staff. “Often times, patient care was inferior because as hard as I tried, I could not be in two-to-three patient rooms at the same time.”

“Additionally, when the family visited, it was a nightmare because when their loved one turned on the call light, they expected an instantaneous response,” she adds. “But nurses often times could not do so due to other pressing patient issues.”

Recognizing the Red Flags That Show a Nursing Home “Nurse Shortage.”

For families who have elderly relatives in senior care facilities, it’s not always so easy to know in advance that the facility lacks appropriate nursing staffing levels.

By Medicare mandate, nursing homes must have a registered in the facility at least eight hours a day. But even those rules are flouted, as senior homes increasingly evade nursing care statutes.

The key in finding out if the home your family member is residing lacks proper nursing care is to ask  a lot of questions, visit the site regularly, and get informed on wat senor care facilities are required to do to satisfy federal government nurse staffing levels.

These tips can help in getting the right information:

Use the Medicare “star” system

Families mulling over nursing home options can log on to Medicare.gov and see how Uncle Sam actually rates their performance. Simply tap in the zip code where the facility is located (add its name is optional) and you’ll get a full review and ranking of the senior care center. A five-star ranking is the best while a one-star ranking is the worst ranking.

Focus on the “staffing section” of the review, where you’ll see how the facility is faring with its nursing levels. “Under staffing, you will see how that facility is performing in general, compared to the national average,” says Susan Scatchell, business development director at Gentle Home Care, in Deerfield, Ill.

Don’t let the hospital and physician direct you

Be an advocate for yourself and do some homework, Scatchell advises. “That way, you are better prepared to ask appropriate questions about the care in the facility they are recommending,” she says. “Ask for choices and then do some homework on your own.” 

Check out the response time to call lights

Call lights enables nursing home patients to get immediate help from a nurse or other medical aid. “Families should check the call lights themselves and see if the aide come into the room to check on the patient and that another aide returns 20 minutes later to follow up, and escort the patient to the bathroom, for example,” Scatchell says.

Check and see if the nursing station is often unattended

If you observe the nursing station unattended frequently, that may be a sign of shortage of a nursing shortage, Scatchell adds. “To be fair, realize that meal times and medication dispensing means staff have to leave the station,” she says.

How does the nursing staff respond to your inquiries?

Do nurses react in a defensive tone or do they respond in a manner that ensures confidence in the desired outcome or concern, when asked questions? “Above all, you’ll want to know the nurse or attendant will do what they said they will do,” Scatchell notes.

What’s the level of patients to nurses?

With senior care facilities, different levels of care have different legal standards and the facility has to disclose what the registered nurse to patient ratio is as well as the aide to patient ratio is, notes Teri Dreher, a board certified patient advocate and chief executive officer at NShore Patient Advocates, in Chicago, Ill.

“Family members should also check to ensure the aides are certified for nursing home care,” Dreher says.

Ask about nursing longevity

Also, ask a care facility nurse about their level of career training in senior care homes and whether that nurse has been at the senior care facility for 10 years or more. “If so, that’s a sign the facility is treating its nurses well,” says Dreher.

Ask about nursing experience in the field

Dreher also advocates asking about the mean experience level of a senor care facility’s nurses. “Are they new graduates or seasoned nurses who have worked in hospitals before? Are they all foreign born? Generally the nurses who have the hardest time gaining employment are new grads and those from other countries,” Dreher says.

The Stakes Are High When Qualified Nursing Care is in Doubt

Scatchell says the ramifications of scarce nursing home care are abundant, and can lead to serious health issues for elderly family members.

“For example, medical error is the third leading cause of death in the United States,” she says. “Patients with Parkinson’s Disease must have their medications on a very timed schedule.  Even 30 minutes can make a world of difference for them.”

Another big issue with nursing home staff shortages is dealing with falls.

“If the patient gets impatient waiting for an aide to assist to the bathroom, they may fall,” Scatchell adds.

Staff shortages can lead to severe emotional issues that can effect patients.

“As a woman, I resent seeing a continent woman in a disposable diaper or depend because of staffing issues,” she adds. “No woman should have to be de-dignified by going to the bathroom in a diaper when they are continent and capable of using the toilet. This also may lead to urinary tract infections or other infections.”

Get Proactive About Your Family Member’s Nursing Care Facility

Since families can’t be at a senior care facility 24 hours a day, and can’t count on a friend for family member for regular help, Scatchell advises getting professional help.

“In that scenario, reach out to a licensed agency for a sitter caregiver to act as a second set up eyes and hands,” she advises. “The caregiver can help facilitate the need for services from the staff.”

“In addition, the caregiver can provide some emotional support and companionship during the day or evening for an individual that is lonely, frightened and scared of being alone.”