REPORT: CNA Staffing Stalled in Nursing Homes with High Minority Populations

Certified nursing assistant (CNA) staffing levels in nursing homes with high percentages of minority residents decreased slightly between 2001 and 2011, while CNA staffing in facilities with fewer minorities increased significantly, a study published in the December Health Affairs shows.

The survey used data from every non–hospital affiliated nursing home in the country. Nursing homes were deemed to have a high concentration of minority residents if at least 35 percent of its residents identify as a member of an ethnic and/or racial minority group. Low-concentration facilities, meanwhile, had less than 5 percent minority residents.

The study showed that low-concentration facilities saw their average CNA staffing hours per resident day increase to 2.23 in 2011, up from 2.04 in 2001.

But over the same span, CNA staffing hours decreased to 1.99 per resident day in low-concentration facilities in 2011, up from 2.05 in 2001.

Findings Raise Concerns

These findings raise concerns “about the potential of impaired care in these facilities, which would disproportionately affect the well-being of [minority residents,” the researchers wrote, noting that higher CNA staffing levels correlate with better care outcomes.

CNA staffing hours remained virtually the same for facilities with a medium-high concentration of minority residents (i.e. between 15.0 and 34.9 percent) while increasing slightly for those with medium concentrations (between 5.0 and 14.9 percent).

The researchers designed the study to examine the effect that higher Medicaid payment rates have had on nursing home staffing hours during the first decade of the 21st century.

Their data shows that staffing rates for registered nurses and licensed practical nurses increased slightly across the board between 2001 and 2011, regardless of facilities’ racial makeup.

Alternatively, policies that reimburse nursing homes with rates that are adjusted for the case-mix of the facility appear to have negative implications for nurse staffing.

— by Matthew Ozga