Changes in nursing home ownership have been found to reduce staffing levels of direct care by making up a large part of the decline in nurse staffing, a new study found.
Research shows that between January 2018 and June 2023, more than 2,500 skilled nursing facilities changed ownership. Among them, nursing homes increased their average daily 2.36 patients and reduced staffing for 0.07 hours per day. The researchers cited that nurse staffing decreases by 0.09 hours per day to become a driver.
As a result, non-nursing staff members increased 0.02 hours per day for residents and 0.52 hours for administrators, the Journal of Long Term Care Medical Association, the Journal of Long Term Care Medical Association, announced last week.
The SNF, which changed ownership, has not always fired staff immediately, reduced pay costs or reduced pay costs, Rachel Prusynski, an assistant professor at the University of Washington's School of Rehabilitation Medicine, told McKnight's Long-Term Care News on Friday. However, their lack of effort to maintain the existing nurse patient ratio has led to significant imbalances.
“(SNFS) increased the patient census right after the ownership change, but failed to keep up with staffing to maintain the same nurse patient ratio as the census increased,” Prussinski said. “Our finding that contractor staffing did not change after SNFS changed ownership also supports an explanation that there was no immediate effort to maintain the same staffing rate as before the change in ownership.”
Staffing outcomes and other adverse outcomes at LTC have been a major stimulant in recent demands from federal agencies for greater transparency in nursing home ownership.
A January report from the Ministry of Health and Human Services said that “expanding integration of the health sector and lack of meaningful competition” was the main reasons for the decline in the quality of patient care and caregiver well-being.
The report also found that acquisitions of Elder Care, inpatient services and drug private equity increased by more than 250% over a decade, up from 352 in 2010 to 937 in 2020, with trading volumes totaling $86 million.
It now aims to eliminate private health operations transactions, including Pennsylvania, New York and New Jersey. States such as California, Indiana, Oregon and New Mexico already have programs that directly or indirectly regulate healthcare private equity.
Prusynski confirms the need for ownership transparency, but notes that the available data on LTC ownership changes is not as specific as it affects guidance that can regulate such transactions. Furthermore, the research does not consider it to be the cause of disadvantaged staffing adjustments by certain buyers.
“The change in ownership we measure is just a general indicator of some of the changing hands of our business. We don't know exactly how the buyer or seller is related. We don't know if the buyer or seller is a private equity company.
Understanding which actors are behind each transaction and which transactions lead to greater staffing and operational changes is important in determining whether a higher regulation is needed, she said.
