Nursing Home Staffing Tricks: Inspection Bump

If you’re looking for a nursing home for yourself or a loved one, the federal agency that oversees nursing homes–the Centers for Medicare and Medicaid Services, or “CMS”–has a great resource to look up and evaluate nursing homes.  It’s called “Nursing Home Compare,” and you can find it here.

But wait!

As I’ve sued more nursing homes and gotten into the weeds on their staffing, I’ve found a disturbing trend.  There can be a “bump” in staffing around the time of the nursing home’s annual “surprise” inspection.  (I say “surprise” because they are not supposed to know when it is happening.)

Why does this matter?

The Nursing Home Compare’s 5-Star rating system evaluates things including staffing.  We know better nurse staffing leads to better resident outcomes.  So it is kind of important to be accurate about staffing.

As it turns out, the staffing picture isn’t based on the staffing data the nursing home submits to Medicare throughout the year.  It’s based on just a 2-week snapshot from just before the inspection.

Now, if nursing homes were really “surprised” by the inspection, that shouldn’t matter, right?  Except, we see the bump, which means something is going on.

Besides the possibility they are tipped off or find out when the inspection is coming, another possible explanation is that the two-week data is submitted on a different form than normal staffing data.  That gives the nursing home the opportunity to inflate the numbers.  not honest, not fair, but a possibility.

So when using the resource, take the rating with a grain of salt.