CARSONCarson study finds nursing homes lack adequate staff


Sunday, May 27th 2001, 12:00 am
By: News On 6



TULSA, Okla. (AP) _ A new report shows thousands of Oklahomans live in nursing homes that fail to meet even the lowest recommended staffing levels, proving the need for more federal oversight and funding, U.S. Rep. Brad Carson says.

Ninety percent of Oklahoma nursing homes did not meet the U.S. Department of Health and Human Services' preferred minimum staffing levels between March 1999 and March 2001, according to the study released Sunday. And 58 percent failed to meet even the lowest federally recommended staffing levels.

The homes that did not meet those levels were more likely to be cited for health and safety violations, including those that caused actual harm to residents, the study found.

``I think this report really corroborates that staffing is a key ingredient in the nursing home mess in Oklahoma,'' said Carson, who requested the report.

Kelly Hardin, president of the Nursing Home Association of Oklahoma, was not surprised by the findings.

``We are well aware Oklahoma's ability to recruit and retain qualified staff is in a state of crisis,'' Hardin said through a spokeswoman. ``Why would a nurse aide choose to work in a nursing home for $6.65 an hour with no benefits when she could work at 7-11 for $9 an hour plus benefits?''

The government's preferred recommended minimum is 3.45 hours of individual care per resident per day, Carson said. At a bare minimum, federal authorities recommend 2.95 hours of such care.

Oklahoma's mandate of 2.14 hours of daily individual care is to increase to 2.87 hours by September 2002, but Carson thinks even that is far too low.

The Democrat plans to introduce federal legislation this summer that would set mandatory staffing levels, give states the right to call upon the federal government to increase Medicaid funding and boost public access to information about compliance.

Carson agreed the staffing problem stems in part from difficulty in hiring and retaining staff.

``That pay is low because we're not putting enough resources into the industry,'' he said, noting that Oklahoma's Medicaid reimbursement rate at the start of 2000 was near the bottom of the nation.

The report ranked Oklahoma 45th among 50 states in the median number of hours of individual care provided to residents. The study was based on Health Care Finance Administration records and conducted by the investigations division of the Committee on Government Reform.

Only 37 of the 385 Oklahoma nursing homes examined met all of the preferred minimum staffing levels.

Federal officials recommend nursing homes provide 1.45 hours of daily care by registered or licensed nurses. In Oklahoma, 225 homes failed to provide an average of even one hour of such care and 103 averaged less than 45 minutes of care, the study found.

Another 42 percent of homes did not have enough nursing assistants to meet the preferred level of 2 hours per day per resident.

Most nursing home care is funded through Medicaid, a joint federal-state program.

New fees levied on nursing homes have helped increase daily patient reimbursement from $66.75 at the start of 2000 to $90.49. But the nursing home association noted that the recent Legislature failed to increase funding for staff levels.

``This year they increased spending on highways and education but not one additional cent was appropriated to caring for the elderly,'' Hardin said.

The Oklahoma Health Care Authority reports a statewide average of 3.21 hours of care per day per nursing home resident, said Esther Houser, the state's long-term care ombudsman. But those numbers include activity and social services staff not involved in direct care.

She supports federal staffing mandates and believes fair appropriations should be earmarked for staffing improvements.

``The fact is that the residents are getting to the facilities more frail and with more complicated medical needs,'' she said. ``We just don't seem to be keeping up with that.''