Since February 2020, nearly 18 percent of healthcare workers in the United States have quit their jobs, and overall employment in the industry is down by 524,000. In October 2021, U.S. hospitals lost roughly 8,000 jobs.
Even many of those still employed by the healthcare industry aren’t working at full capacity. Use of sick time by healthcare employees is up 50 percent for full-time clinical staff and more than 60 percent for part-time employees.
Although news of a predicted physician shortage has been widely debated, more recently the trend of a lack of nurses has been discussed, especially since the height of the COVID-19 pandemic. One widely-cited study projects a shortfall of 510,394 registered nurses by 2030. Other reports project that 1.2 million new registered nurses will be needed to address that deficit. There are multiple reasons for a shortage in the nursing profession including high turnover, inequitable workforce distribution and nurses moving away from direct patient care or leaving the health field altogether because of stress.
The Effects of Insufficient SNF Staffing
There are an estimated one million individuals employed by the more than 150,000 skilled nursing facilities (SNFs) across the U.S. providing 24-hour support and nursing care to the almost 1.5 million people living in them. According to data from the National Center for Health Statistics, there are an estimated:
- 4,600 adult day services centers
- 12,200 home health agencies
- 4,300 hospices
- 15,600 nursing homes
- 28,900 residential care communities
SNFs in the U.S. are required to have sufficient nursing staff with the appropriate competencies to assure resident safety and attain or maintain the highest practicable level of physical, mental, and psychosocial well-being of each resident. According to the Centers for Medicare & Medicaid Services (CMS), each facility must have sufficient numbers of RNs, LVNs/LPNs and CNAs on a 24-hour basis to provide nursing care to all residents, including a charge nurse on each shift, an RN for at least eight consecutive hours a day, seven days a week, and a designated RN to serve as the director of nursing on a full-time basis unless the facility has a CMS waiver.
Even with the government guidelines for SNFs, there is a wide range of actual staffing levels in U.S. skilled nursing facilities. Also, although staffing levels are one of the most important determinants of whether a SNF is providing adequate care, research has shown that 40 percent of U.S. nursing units are understaffed, and 33 percent of them are inadequately staffed.
Understaffing and unqualified staffing in SNFs put elderly residents at risk of neglect and abuse, reduces the standard of care and can cause tragedies, including medical errors, deadly falls and bed sores. If SNF employees are being over-scheduled and overwhelmed by their duties, they may be more likely to quit. Some effects of understaffing in skilled nursing facilities include:
- Dropped residents from being moved by only one staff member when two are needed
- Falls that occur when residents try to go to the bathroom on their own because no one comes when they call
- Painful and infected bedsores caused by inadequate staff available to move or turn patients
On the contrary, higher nurse staffing improves both the process and outcome measures of quality at SNFs. Numerous studies of skilled nursing facilities reveal a strong positive relationship between the number of SNF staff who provide direct care to residents on a daily basis and the quality of care and quality of life of residents. In addition, higher registered nurse (RN) staffing levels at SNFs are associated with:
- Fewer pressure ulcers
- Lower restraint use
- Decreased infections
- Lower pain
- Improved activities of daily living (ADLs) independence
- Less weight loss, dehydration and insufficient morning care
- Less improper and overuse of antipsychotics
- Lower mortality rates
Streamlining SNF Staffing with Health Information Technology
The use of health information technology (HIT) systems has the potential to improve safety, communication and productivity in skilled nursing facilities. SNF administrators and staff have frequently reported that HIT improved communication, and research suggests that it can improve scores on SNF quality indices, resident outcomes such as maintenance of activities of daily living, range of motion and bed mobility and clinical support to reduce rates of adverse drug events and increase identification of medication errors.
At RingRx, we designed our next-generation cloud communications platform to simplify and improve provider and staff communications for SNFs in communities both large and small, urban and rural. We deliver the highest-quality VOIP audio and full-spectrum business-class phone system and offer the latest office and mobile technologies to help streamline communication in your facility. Learn more by reading our eBook, “Scalable and Streamlined Communications Technology for Skilled Nursing Facilities.”