I recently attended a nursing conference where the central theme was elder abuse and neglect. One of the presenters was Charlene Harrington, Ph.D. of UCSF, a professor of nursing and sociology, who is considered an expert on nursing home staffing.
According to Harrington the nursing home staffing picture in California isn’t pretty. She said that there are over 12 million deficiencies in U.S. nursing homes annually, and stated that approximately one-quarter to one-third of all nursing homes provide substandard care.
According to Harrington, sufficient staffing is the number one indicator of the quality of care one can expect to receive in a nursing home. California requires that a licensed skill nursing facility provide at a minimum of 3.2 hours of nursing, per patient, per day. While this is a minimum standard, most California facilities view it as the threshold, striving only to meet it. In fact, RN care has been declining in California, which now has one of the lowest RN per patient, per day ratios in the country.
Harrington says those that view California’s 3.2 hours as more a ceiling than a floor are operating on dangerous footing, emphasizing that 3.2 hours is a minimum requirement. Adequate care for most facilities, she says, requires much more nursing, and believes the law should be changed to require 4.1 hours per patient, per day.
Ultimately, those facilities that provide more licensed nursing per patient, per day, tend to have fewer problems and a more satisfied patient population.