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| Stanford Care and Rehabilitation reported only 23 minutes of registered-nurse care per patient day in the last quarter of 2019. It's had many deficiencies, and 18 of its residents have died of covid-19. |
Nursing homes in Kentucky reported averaging 45 minutes of registered-nurse staff time for each resident day in the last three months of 2019, "the most recent period for which data is available from the U.S. Centers for Medicare and Medicaid Services," Cheves reports.
But the eight with the most deaths "reported an average of only 24 minutes," he reports. "For example, Landmark of Louisville Rehabilitation and Nursing — with 18 deaths so far attributed to covid-19 — reported just 12 minutes of RN staff time per resident daily, the lowest of the group."
The other seven, their deaths and average RN times are Rosedale Green, Covington, 29, 16 minutes; Florence Park Care Center, 25, 16 minutes; Stanford Care and Rehabilitation, 18, 23 minutes; Pine Meadows, Lexington, 25, 27 minutes; Mills Nursing and Rehabilitation, Mayfield, 23, 29 minutes; Ridgewood Terrace, Madisonville, 24, 33 minutes; and Essex Nursing and Rehabilitation Center, Louisville, 21, 37 minutes.
Most of the eight "are owned by for-profit corporations or privately run investment portfolios," and most "had low quality ratings from the federal government and infection control problems well before the novel coronavirus began to kill large numbers of their residents last spring," Cheves reports. "But beyond these other common threads, the link between registered-nurse staffing levels and covid-19 infections and deaths at nursing homes has been identified in several studies."
The author of the latest study, Charlene Harrington, nursing professor emeritus at the University of California-San Francisco, told Cheves, “Nursing homes without enough RNs find themselves in trouble. It results in terrible quality of care, even when you’re not in the middle of a pandemic.”
Kentucky RNs earn about $21,000 a year more than licensed practical nurses or licensed vocational nurses, Cheves reports, and "usually are the only ones on a nursing-home staff qualified to create an infection-control plan, spot and assess infections and determine who should see a doctor or go to the hospital, Harrington said."
Kentucky’s state long-term care ombudsman, Sherry Culp, told Cheves that some nursing-home chains save money by rotating nurses between facilities and not assigning them to individual locations, which requires more nurses. The main nursing-home lobby in the state, the Kentucky Association of Health Care Facilities, didn't respond to a call seeking comment, Cheves reports.
Federal law requires nursing homes to have "sufficient" staff to meet residents’ needs, "including a licensed nurse — an RN, LPN or LVN — on duty at all times," Cheves notes. "Some states set their own more rigorous staffing standards for nursing homes, but Kentucky long has resisted such calls, dismissing them as impractical."
Rep. Kimberly Poore Moser, R-Taylor Mill, chair of the Health and Family Services Committee in the state House, told Cheves, “It’s critical that we have enough qualified staff, but it’s really hard to hire and retain qualified staff when the salaries just aren’t competitive.”
Nursing-home watchdog Wanda Delaplane "said the General Assembly should be shocked enough by the hundreds of coronavirus deaths in nursing homes to finally pass staffing requirements," just as it does with adult supervisors in child-care centers, Cheves writes, quoting her: “It all comes down to the fact that you can’t give good care if there aren’t enough people on the floor to provide it.”
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