Staff Vacancies Just Got A Little More Important & Complicated

You can’t go to a health and human service meeting where the topic of workforce doesn’t come up. Common topics include retention of direct service professionals, the shortage of psychiatrists, tech-enabled task shifting, and paying for productivity and performance (for more, see the presentation from last week’s 2018 OPEN MINDS Executive Leadership Retreat, How To Retain & Grow Direct Support Professionals).

Payers have discovered the importance of the right team and the right number of team members too. Case in point—in July, the Centers for Medicare & Medicaid Services (CMS) released updated Nursing Home Compare Star Ratings. And for the first time, those ratings used payroll-based journal (PBJ) staffing data to substantiate nurse staffing ratios.

The result was that 8.9% of facilities (1,387) had their star rating for direct care staffing downgraded to one star (out of a possible five). And for about half of those skilled nursing facilities, their overall star rating also dropped (see Medicare Nursing Home Star Ratings Downgraded For 8.9% Of Nursing Homes Due To Inadequate Staffing). Perhaps even more interestingly, consumers and their families can also view the average number of residents per day and the average number of hours certain staff members (i.e., physical therapists, registered nurses, and nurse’s aides) spend with consumers compared to the national and state averages.

We did write last week that consumers don’t always pay attention to quality ratings (see How Do Consumers Pick A Provider? It’s Often Not Quality). But, I would argue that ratings will grow in importance with consumers, and that payer and health plan managers do pay attention to these rankings and ratings. And as data aggregation becomes easier, I suspect that transparency in areas like staffing will become expected, and required, across the board.

While transparency in staffing and ratings incorporating staffing functions are increasing, staffing challenges for health and human service provider organizations continue to grow. These big challenges include high turnover rates, the cost of staff vacancies, the impact of addictions on personnel, and the reductions to the foreign labor pool.

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