Why Five-Star ratings should measure staff retention, not staff ratios

Here’s my latest article on McKnight’s Long-Term Care News:

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Why Five-Star ratings should measure staff retention, not staff ratios

The Five-Star Quality Rating System reports the results of health inspections, staffing and quality measures. I suggest we replace the current staffing measure with one tracking staff retention.

Here’s my logic:

The existing staffing score is the ratio of nursing staff to residents, taking care needs into account. In allowing for self-reporting of the data, some nursing homes overstated their resident/staff ratio. It therefore hasn’t been a particularly accurate measure of staffing.

It also misses the fact that while some residents have low-acuity physical health needs, they — or their family members — may have high-acuity emotional or mental health needs that require a great deal of staff time and attention. In such situations there are enough workers for the facility to be compliant technically but understaffed in reality.

If we shift to a system that measures staff retention rather than staff ratio, however the whole picture changes.

Staff turnover is a strong signal that something is wrong with a nursing home.

As I noted in an earlier post here, “Reducing Turnover in LTC,” employees tend to leave facilities not just because the pay and benefits are low, but also because of a high workload, poor staffing, unsatisfactory work conditions and a lack of appreciation. Unless they’re older, invested in the facility and perhaps looking forward to retirement benefits, employees depart when a facility isn’t a good place to work.

If a nursing home isn’t a good place to work, it’s an even worse place to live.

Residents and their families want clean, safe environments with quality care and reasonable food — and they especially want workers who know and respect them. High turnover makes meeting these expectations virtually impossible.

For the entire article, visit:

Why Five-Star ratings should measure staff retention, not staff ratios

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