Staffing levels are below average at about one of every four nursing homes in Western New York, and that’s contributing to their mostly below-average overall ratings from the federal government, according to a Buffalo News analysis of federal data.
Nursing home administrators say they struggle to attract and keep nurses. Union officials blame what they call steep cuts to staff, pay and benefits.
Only one nursing home in the region, Jennie B. Richmond Nursing Home in Springville, received the highest, 5-star rating for total staffing from the Centers for Medicare and Medicaid Services.
Twenty-one other facilities received a 4-star rating, an above-average score.
Thirty-four nursing homes received 3 stars, an average rating.
The remaining 17 facilities received below-average ratings. Nine nursing homes received a 1-star rating, the lowest possible score, for staffing, while eight other facilities received 2 stars from the agency.
“The 1-star ratings are a direct result of cost-cutting,” said Todd P. Hobler, a vice president of Local 1199, Service Employees International Union, which represents 4,200 nurses and other workers at 30 area nursing homes.
Hobler said his union has had a poor experience with out-of-town operators of nursing homes, particularly those that replace non-profit operators. Many come in and seek concessions from workers in order to drive down costs, he said. Workers are a target because staffing makes up about 70 percent of the cost of operating a nursing home, he said.
“It’s a crisis, and that is true in more than one nursing home,” Hobler said.
Staffing is one of three main components that make up Nursing Home Compare ratings compiled by the Centers for Medicare and Medicaid Services. The largest component is the health inspection rating, which is based on an inspection conducted by the state Health Department, and the other is the quality measure component that includes metrics ranging from how often residents are injured in falls or experience pain.
Nursing home administrators and others call staffing a key indicator because problems at nursing homes often can be traced to inadequate staffing or poorly trained workers. Nursing homes report their staffing levels to the federal agency, which rates both total staffing and registered nurse staffing.
“The staffing levels have long been recognized as a critical component to quality care. Study after study has shown that,” said Richard Mollot, executive director of the Long-Term Care Community Coalition.
Area nursing homes with above-average staffing posted an average overall rating of 3.6 stars, out of 5-star scale, while facilities with below-average staffing posted an average overall score of 1.3 stars, according to The News’ analysis of the federal data.
The agency calculates its total staffing rating as the total staffing hours per resident per day for all registered nurses, licensed practical nurses and certified nurse aides. For its registered nurse rating, the agency uses the registered nurse staffing hours per resident per day.
About 12 percent of nursing homes in the region received a 1-star rating for total staffing in the agency’s most recent ratings, released this month, about the same as last year. That’s half the 23 percent of nursing homes in the state that received a 1-star rating.
For registered nurse staffing, 12 percent of nursing homes in Western New York received a 1-star rating, the lowest possible rating, while 15 percent received the top rating of 5 stars. Four nursing homes in the region saw their total staffing rating drop at least two stars between 2015 and 2016: Batavia Health Care Center in Batavia, Villages of Orleans in Holley, Waterfront Center for Rehabilitation and Healthcare in Buffalo and Chautauqua Nursing and Rehabilitation Center in Dunkirk.
Waterfront didn’t make any cuts to its nursing staff since Colin Hart took over as administrator in late March. The nursing home has eight registered nurses working throughout a typical weekday.
Hart said he doesn’t know why its registered nurse rating dropped from 4 stars in 2015 to 1 star in 2016.
“Once again, it’s hard to explain,” Hart said.
Two of the homes that saw steep star rating drops, Villages of Orleans and Chautauqua, have changed or are in the process of changing from county government control to for-profit ownership.
Comprehensive Healthcare Management Services bought the Villages of Orleans facility from Orleans County and is awaiting state approval to operate the home.
The for-profit Comprehensive owns and operates Comprehensive at Williamsville, the former St. Francis of Williamsville nursing home, which the company took over last year. The home saw its total staffing rating fall by one star to a 3-star rating in 2016, and its registered nurse rating fall two stars to a 3-star rating.
Mordy Lahasky, the managing member of Comprehensive at Williamsville, said the company ran into problems because a number of workers at the home, which previously was owned by Catholic Health System, left to take positions at other Catholic Health facilities. The company has struggled to find replacements. The home has 20 registered nurses, including three recent hires.
Comprehensive did not cut staff upon taking over St. Francis, and it did not cut wages, Lahasky said. The company, instead, is boosting starting wages to try to attract new workers and to make pay competitive with other industries, including fast food, which will see a boost in minimum pay in the coming years. Ending a pension that had been offered by Catholic Health was the only change the company made, he said.
“We’re new in the community, and it’s just been a little bit of a struggle to find the right people,” Lahasky said.