DHHS reported a 32 percent increase in deaths among Medicare patients in U.S. nursing homes last year. There were 169,291 more deaths among Medicare patients in nursing homes in 2020 than in 2019. About 40% had COVID-19. Compared with 2019, death rates were higher every month last year, with two spikes, in April (81,484 deaths) and in December (74,299 deaths).
“We knew this was going to be bad, but I don”t think even those of us who work in this area thought it was going to be this bad,” Harvard health policy professor David Grabowski, Ph.D., told the Associated Press. “This was not individuals who were going to die anyway,” he noted. “We are talking about a really big number of excess deaths.”
Covid-19 ravaged nursing homes across the United States — killing more than 132,000 residents and more than 1,900 staff members. It also highlighted the predictable and dire consequences of short-staffing long-term care facilities. A 2001 study by CMS, responsible for regulating nursing homes, found staff should spend at least 4.1 hours per resident daily. But there are no federal requirements for daily nursing hours per resident.
“Seventy-five percent of the nursing homes had inadequate staffing before the pandemic started,” said Charlene Harrington, a professor emerita at the University of California, San Francisco. “It’s not surprising that they weren’t able to cope with it.”
The long-standing staffing shortage and high turnover rates left facilities scrambling, and unable to finish their tasks each day. This neglect or missed care is a symptom of staff shortages. Short-staffing leads to adverse events including pressure injuries, medication errors, infections and abuse.
Nationally, registered nurses in nursing homes had an average turnover rate of more than 140% in 2017 and 2018, according to a March 2021 report published in the journal Health Affairs. The report found certified nursing assistants had a rate of more than 129%. Some facilities had annual total nursing staff turnover rates of more than 300%.