Many California Nursing Homes Are Understaffed, Study Says

Staffing at a third of California’s nursing homes fails to meet the state’s minimum requirements, according to a report released Tuesday by the California Department of Health Services.

The Legislature ordered the study in January to determine whether the minimum staffing requirement should be increased for California’s 1,400 nursing homes.

The report concluded that it should not, in part because of a shortage of available nurses.

“There is a real work force shortage for health care workers in general,” said Brenda Klutz, a deputy director for the department. “That is the primary reason more facilities aren’t meeting the minimum.”

Klutz said fewer certified nurse assistants are entering the field than the number leaving.

The findings of the study, which was based on a sampling of 111 homes, challenge the views of advocates of AB 1075, a bill that would require at least one nurse for every five patients. The current minimum standard is equivalent to one nurse for every nine patients. The bill, which passed the Assembly early this month, is pending review by the Senate Health Committee.

Pat McGinnis, executive director of California Advocates for Nursing Home Reform, called it “a very cautious report. Their conclusions are not really conclusions. If we were running a budget surplus there probably wouldn’t be this cautionary a report.”

Over the last two years, the state has allocated $470 million to nursing homes to improve the quality of care. But critics say the money never resulted in increased staffing.

McGinnis said the study allows the Health Department to avoid recommending that the state spend more money.

“I can imagine what will come out of this is more studies, more funding for grants and more meetings, but no money for staffing,” she said.

But Diana Bonta, state health director, said that until the state has “data to indicate that the minimum level in nursing homes needs to be increased,” it will focus on making sure homes at least meet current requirements.

The study recommended that the state:

* Randomly investigate staffing levels at a portion of the nursing homes each year.

* Conduct research to determine the correlation between the quality of care and staffing

* Increase Medi-Cal reimbursement rates at facilities that increase staff salaries and benefits.

Of the homes surveyed, one received a citation, which may carry a $1,000 fine, and 37 must submit plans to improve staffing.

Supporters of an increase in minimum staffing said the report leaves them cautiously optimistic.

“We are realistic about the budget situation we are in, which is different than what we were in six months ago,” said Beth Capell, spokeswoman for the Service Employees International Union. “We recognize it may take us a little longer than we thought to get to it.”