? A nursing home staffing shortage requires a rapid solution because residents are suffering as a result, Sen. Chuck Grassley, chairman of the Special Committee on Aging, said today."Today we have the first part of the most comprehensive study of nursing home staffing shortages to date," Grassley said. "The study links staff shortages to poor care. It's a common-sense relationship, but it hasn't been well-documented until now. The study is years late. Now we have to make up for lost time. Nursing home residents are suffering every day."Grassley's comments came at a hearing, "Nursing Home Residents: Short-changed by Staff Shortages, Part II," at which researchers presented the first part of a nursing home staffing study that Congress mandated in 1990, with an original due date of Jan. 1, 1992. The initial findings include:Nationwide, more than half ? 54 percent ? of nursing homes are below the suggested minimum staffing level for nurses aides. These aides are the lowest paid and least trained of all nursing home staff, yet perform most of the feeding and bathing of patients.Nearly one in four nursing homes ? 23 percent ? were below the suggested minimum staffing level for total licensed staff.Nearly one-third ? 31 percent ? were below the suggested minimum staffing level for registered nurses. The minimum staffing level for registered nurses is 12 minutes per patient per day.The report concludes that low staffing levels contribute to an increase in severe bedsores, malnutrition and dehydration, which lead to increased hospitalization. Grassley said the findings document what he has heard many times while working to improve nursing home quality of care.Grassley said he has two immediate action items to improve staffing in nursing homes.First, he said he plans to look into tying a funding increase for nursing homes to staffing. Congress is considering a proposal to give the nursing home industry some of the Medicare money cut in the Balanced Budget Act of 1997. A give-back bill is likely in September. Based on today's report, Grassley said he is unwilling to give the nursing home industry a blank check. The industry has argued repeatedly that it needs more money to hire more staff. If the industry receives more money this year, Grassley said, he would like to see that increase tied to staffing. He said he plans to develop a proposal to that effect and will work with the administrator of the Health Care Financing Administration to do so.Second, Grassley said he plans to look into options to encourage states to increase Medicaid rates for nursing homes if they agree to hire more staff with the increased rates. The majority of revenue in nursing homes is Medicaid, not Medicare. Grassley said his proposal will take some time to develop, but he plans on making it a priority and will turn to various stakeholders for assistance.Later, Grassley said, he plans to receive two more pieces of information that are critical to solving the staffing problem:The second piece of the staffing study. The second part will expand the analysis and include an assessment of the costs of implementing minimum staffing requirements. Grassley said he hopes the second part comes quickly.An analysis of how the nursing home industry spends its money. Grassley said nursing homes accept $39 billion a year of taxpayer money to care for residents. At Grassley's request, the General Accounting Office is studying how nursing homes spend this money. He will receive the report early next year."The suffering of nursing home residents is intolerable," Grassley said. "Bedsores and malnutrition turn the stomach and hurt the conscience. They beg for a solution, the sooner, the better."
