MDS Alert

Published on Thu Nov 08, 2018 PDF

The long-term care industry is battling dropping occupancy rates while needing to boost staffing to meet quality measures.

If you’re looking around your facility and seeing more open beds than you remembered in the past, it’s not just your imagination. Skilled nursing facility occupancy rates are falling.

“Occupancy decreased 79 basis points to a new low at 81.7% as of the second quarter 2018. Year-over-year occupancy decreased 137 basis points from 83.1%,” says the National Investment Center (NIC) in a recently released Skilled Nursing Data Report: Key Occupancy & Revenue Trends.

That means that almost 1 in 5 beds are empty in any given skilled nursing facility. While there’s a growing population of elderly people who need skilled nursing care — a population whose numbers will continue to increase as baby boomers age — there are also more options for would-be residents than in years past. For example, assisted living, independent living, and even home health services are making a noticeable dent in skilled nursing facility occupancy rates.

“The second quarter decrease in occupancy was evident across all geographic areas, with rural areas experiencing the sharpest decline, dropping 89 basis points quarter-over-quarter,” says Bill Kauffman, senior principal at NIC, in a blog post about the report.

Maintain Appropriate Staffing Rates

One silver lining to lower occupancy rates may be the reality that facilities may have an easier time actually meeting staffing requirements. Data from the payroll-based journal (PBJ) system has confirmed that many facilities weren’t staffing adequately for the number and needs of residents.

The Kaiser Health Network (KHN) conducted an analysis of the data submitted by skilled nursing facilities.

“KHN’s analysis of the payroll records found thousands of nursing homes had one or more days where the facilities did not report a registered nurse on duty for at least eight hours, as required by Medicare,” says Jordan Rau, a senior correspondent at Kaiser Health Network.

These ratings are published on the Nursing Home Compare, beginning in July 2018, but the data hasn’t necessarily reflected individual facilities’ star ratings. And if mistakes were made on either end of reporting, they won’t necessarily be corrected until the next quarter’s data is submitted and published.

Beware: KHN, The New York Times, and other organizations and publications are bringing staffing rates to the attention of potential residents and their families. Honestly reporting and construing staffing levels is more important than ever to keep your facility’s beds filled, especially at this moment when occupancy rates are falling.

Resource: The KHN has created a tool that allows anyone to check the nursing staff rates of any facility within the country, which you can access here: https://khn.org/news/look-up-how-nursing-home-staffing-fluctuates-nationwide/.

Unsurprisingly, the lowest staffed days usually fall on weekends and holidays. With high staff turnover throughout the long-term care industry, as well as a dearth of qualified and enthusiastic potential employees, facilities may be feeling especially squeezed to provide the amount and frequency of care residents need, while also helping staff achieve work/life balance.

Envision New Roles

Some facility administrations are finding clever ways to provide the staff power needed to deliver high-quality care without overburdening staff in particular roles. If you find that your facility feels understaffed, especially for the basic assistance tasks like getting meals ready or tidying up resident rooms, consider a new role by staffing for community support. This is a great way to get local high school students comfortable with residents, but also a way to hire people who can contribute to your facility running more smoothly, even if they may not be qualified to be certified nursing assistants or fill other care roles. Doing so may also free up your nursing staff to focus on nursing!