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RNs and CNAs Work Fewer Hours in Nursing Facilities that Serve Predominately Ethnic and Racial Minority Residents

A December 2015 Health Affairs study of freestanding Skilled Nursing Facilities (SNFs) from 2001 thru 2011 found that registered nurses (RNs) were less likely to work at nursing homes with high concentrations of racial and ethnic minorities. The study reports on significant health disparities for racial and ethnic minority SNF residents. Facilities with low concentrations of minorities were distinguished from SNFs with medium concentrations (5.0-14.9 percent), medium-high concentrations (15.0-34.9 percent), and high concentrations (=35 percent) of minorities. Although RN staffing levels increased slightly across-the-board for all nursing facilities during the 10-year period, facilities with high concentrations of racial and ethnic minority residents “showed persistently lower RN hours per resident day.” The study noted that “facilities in the high-concentration group also showed persistently higher [licensed practical nurse] LPN hours per resident day, compared to the low-concentration group.” Regrettably, the authors reported that “facilities in the high-concentration group had a lower nurse skill mix than those in the low-concentration group.” Additionally, certified nurse assistant (CNA) hours were reduced at facilities with greater numbers of ethnic and racial minority residents in recent years as a result of 1) the greater likelihood for nursing homes with higher concentrations of racial and ethnic minorities to receive relatively lower payments in the form of Medicaid dollars; and 2) recent economic trends caused by the recession. With respect to the use of CNAs, the study found that the number of CNA hours decreased in the higher-concentration group from 2.08 to 1.99 hours per day between 2008 and 2011.

Source/more: Center for Medicare Advocacy/Health Affairs


David Wingate is an elder law attorney at the Elder Law Office of David Wingate, LLC. The elder law office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick and Montgomery Counties, Maryland.

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