Advocates push for increased staffing at nursing homes

Advocates for better long-term care for elders gave sometimes emotional testimony today as they asked a Senate committee to consider raising minimum staffing levels at nursing homes.

"We realize what we're asking for is a significant change," said Mitzi McFatrich, executive director of Kansas Advocates for Better Care. "But we believe it is reasonable to set a minimum standard for direct nursing care at the beginning of a major overhaul to the Medicaid system."

The administration of Gov. Sam Brownback is working to expand managed care to all currently on Medicaid, including those in nursing homes. The governor's KanCare plan is scheduled to start Jan. 1, 2013, contingent upon federal approval.

In Kansas, nursing homes are required to give direct staff care for at least 1.85 hours per resident per day, and to average at least 2.0 hours per day throughout the week. The minimum staffing level is one qualified employee per 30 residents, which translates to 2.06 hours per resident per day.

Qualifying staff are registered professional nurses, licensed practical nurses, nurse aides, nurse aide trainees, medication aides and paid nutrition assistants.

Several people who testified cited a 2002 study by the Centers for Medicare & Medicaid Services that recommended at least 4.85 hours of combined staff time per resident per day. Maren Turner, director of AARP Kansas, said legislators should consider raising the state minimum to at least that level.

"Residents in facilities that fell below the minimum staffing thresholds (recommended by CMS) were at a significantly greater risk of hospitalization for potentially avoidable causes, lack of functional improvement, incidence of pressure sores and skin trauma ... and weight loss," Turner said.

Committee members also heard several personal stories, including one from Barbara Braa, whose mother lives in a nursing home.

"If you cared for a child in your home and only gave them two hours of care a day, somebody would be at your door taking them away. And that's all we provide," for the elderly, Braa said, fighting back tears.

A report is expected in the next few weeks from the Legislative Division of Post Audit on how increased staffing levels at nursing homes would affect state spending.

Turner and others asked committee members to consider scheduling an interim hearing on the issue after the report is available.

There are 342 nursing homes in Kansas. McFatrich said that all facilities averaged 3.59 hours per resident per day in 2010. But the averages for individual nursing homes ranged from 1.4 hours to 5.7 hours. She said 151 nursing homes fell below the state average.

Senate Bill 184 would incrementally raise the minimum staffing levels to 4.44 hours per day. The bill was introduced last year but no action has been taken on it.

→ More from today's committee meeting at

Tagged: medicaid, neglect, staff, kansas, nursing, homes, kancare, aging, cms, care


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