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Increase In Agency Nursing Home Staff Raises Concerns About Care

A woman in a wheelchair is seen navigating a nursing home hallway surrounded by medical equipment and staff.

How common is it for nursing homes to have temporary staff?

Nursing homes have often used independent staffing agencies to help address temporary staffing shortages. For example, when staff members go on vacation or are out sick. However, a study has found that since the pandemic, nursing homes have increasingly relied on temporary agency staff, raising concerns about the quality of care residents are receiving.

The study, published in the medical journal Health Affairs, examined Payroll-Based Journal (PBJ), Nursing Home Compare Archive data, and Medicare Cost Reports from 2018-2022. Researchers noticed a clear trend during that time.

COVID-19 played a clear role

"Before the pandemic, most nursing homes did not rely on agency staff. Since the pandemic, the use of agency staff has become more common; it is more expensive and may be associated with lower-quality care," the study's authors noted.

In 2018, 23 percent of nursing homes used agency nursing staff, which accounted for roughly 3 percent of direct nursing hours worked. By 2022, 49.1 percent of nursing homes used agency nursing staff, accounting for about 11 percent of direct nursing hours worked.

The study notes that the beginning of the pandemic in 2020 was a "clear inflection point" that saw the share of nursing homes using agency staff steadily rising.

Concerns about care and increased labor costs

Researchers also compared the use of agency staff with CMS's Five-Star Quality Rating System, using the overall health inspection and quality-measure star ratings. The use of agency staff was associated with lower average overall and health inspection star ratings, but not with the quality-measure star rating.

However, the authors note their analysis does not identify whether the use of agency staff was the cause of the star rating, as many other factors can play a role.

Staff shortages have long been a problem at nursing homes throughout the country. It's clear that many are addressing that problem through the use of agency staff. The study found that 13.8 percent of nursing homes had agency staff present every day in 2022, up from 5.7 percent in 2018.

This use of agency staff is also increasing labor costs for nursing homes, according to the study. In 2018, registered nurses from staffing agencies cost $17.20 more per hour than nurses who were directly employed. In 2022, that discrepancy rose to $23.93.

Why staffing matters at nursing homes

When nursing homes do not provide adequate staffing, residents face an increased risk of neglect. For instance, residents may develop serious infections like sepsis or bedsores due to lack of proper care. Additionally, inadequate staffing may contribute to instances of malnutrition or dehydration among residents. Furthermore, residents may be more susceptible to falls or medication errors when there aren't enough staff members available to provide proper supervision and assistance.

Nursing home neglect can have devastating consequences, resulting in severe injuries or even fatalities. If you suspect that a loved one is experiencing neglect in an Alabama nursing home, seeking legal assistance is crucial. At Shuttlesworth Law Firm, P.C., we are dedicated to advocating for the rights of nursing home residents and holding negligent facilities accountable. Our dedicated legal team can help you navigate your case, gather evidence, and pursue legal action on behalf of your loved one. Contact us today for a free consultation to discuss your concerns and explore your potential legal options.

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