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Nursing homes in the Carolinas well below recommended staffing average

The discovery of low staffing numbers comes after we identified sex offenders living in nursing homes across the state, including one now charged with murdering a fellow resident and raping another.

CHARLOTTE, N.C. — Most nursing homes in the Carolinas don't have enough staff to properly give residents the attention recommended, according to a review of newly released federal data.

Long Term Care Community Coalition Executive Director Richard Mollot expressed concern, especially about North Carolina's numbers, after providing us with the staffing data.

"The NC average is frightening and people – particularly policymakers – should know," he said.

Mollot said the average total direct care staffing hours per resident day is the key quality indicator. A 2001 federal report to Congress identified 4.1 hours per resident day as the minimum. Mollot said people should find nursing homes that are at or well above that number.

Unfortunately, most are well below 4.1, according to federal records. In fact, the data show just 16% of all nursing homes in the Carolinas are at or above that number. North Carolina nursing homes average 3.3 direct care staffing hours per resident day, while South Carolina nursing homes average 3.8, according to the data. The number is determined by RN, LPN and CNA hours and nursing home census numbers.

"The NC average staffing across facilities is distressingly low," he said. "Staffing is the key quality indicator for nursing homes. It’s so important 52 weeks out of the year. Twenty-four hours a day, seven days a week, no excuses, because nobody wants to be raped on Christmas.”

The latest discovery comes after we identified sex offenders living in nursing homes across the state, including one now charged with murdering a fellow resident and raping another.

A North Carolina Industry group told us judging the quality of a nursing home based solely on staffing is "misguided," saying both the number and quality of staff are important, as well as other factors.

"There are nursing homes with high staffing levels but poor outcomes, and there are nursing homes with low staffing but good inspection reports and good quality outcomes," NC Health Care Facilities Association Executive Vice President Polly Welsh, RN, MPH, said. "A combination of factors contributes to quality of care, including staff training and health outcomes."

Specific to staffing, Welsh said the industry is struggling to recruit and retain staff, saying the association is working to increase resources for staffing. 

"Many providers around the country face recruitment and retention challenges," Welsh said. "Nurses and nurse aids are among the fastest growing occupations, but supply is not keeping pace with care demands."

She said the best way for any potential resident or family to understand the care provided in any nursing home is to visit the nursing home in person.

For context, the national care staff average is 3.4 hours of total direct care staff time per resident per day, including 0.5 hours of RN staff time per resident per day, according to Mollot.

For comparison, South Carolina’s averages are 3.8 (Direct Care) and 0.5 (RN) hours compared to 3.3 (Direct Care) and 0.3 (RN) in North Carolina.

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