Of the thousands of nursing homes that are understaffed, federal regulators only cited 4 percent and fined even fewer, according to a USA Today investigation.
The nursing home workforce has been shrinking since 2019, when it averaged 3,374 workers. So far in 2022, the number of employees at nursing homes hovers right below 3,000, according to data from the U.S. Bureau of Labor Statistics.
The federal government rarely enforces its benchmarks for its staffing requirements, the investigation found, as about a third of facilities failed to meet multiple staffing criteria.
Nurses told USA Today they have received threats of being fired if they speak honestly with regulators. James Lovette-Black, a former nursing home inspector in California, said some nursing homes packed their facilities with staff before inspections to avoid their public ratings falling.
Regulators have three ways to document staffing and are set to propose a fourth approach in 2023, but nursing home residents have experienced less care and ignored medical tasks for years because of the shortage, according to USA Today.
The investigation's estimates are conservative, according to Charlene Harrington, PhD, a staffing levels and nursing home quality researcher.
Regulators have "not even been enforcing the bare minimum," Dr. Harrington, a professor at UCSF, told USA Today.
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