[Mpls] Vet's Home violating rules for direct care staffing

[Socialist2001 at cs.com]

With current staffing patterns reported by the Star-Tribune, it is clear that 
the Vets Home, providing less than 0.3 hours of direct nursing care per 
resident day, is in violation of MN health Dept regulations.  No MN nursing home 
may legally provide less than 0.95 hours of direct nursing care per resident 
day.  

If the average level of direct care required by Vets Home residents is 
comparable to that of the average MN nursing home, Vets Home would have to increase 
the number of hours worked by Nurse aides 10 fold in order to comply with MN 
Dept.of Health regulations. I would be surprised if any MN nursing home is in 
compliance with minimum staffing regs.

According to a federal HHS report dated November 2003, MN Health Department 
regulations require "an average nursing home" to provide a minimum of 3.0 hours 
of direct care per resident in a 24 hour period. The absolute minimum 
requirement is 0.95 hours per resident day or 2.0 hours per **standardized resident 
day,** whichever is greater [presumably in facilities licensed to provide 
"skilled care"] 

Federal HHS report: 
State Experiences with Minimum Nursing Staff Ratios for Nursing Facilities: 
Findings from Case Studies of Eight States

 Jane Tilly, Dr.P.H., Kirsten Black, M.P.P., and Barbara Ormond, Ph.D.
The Urban Institute

 Jennie Harvell
U.S. Department of Health and Human Services

 November 2003
http://aspe.hhs.gov/daltcp/reports/8state.htm#append4MN
 
"Before 2001, three nursing staff standards applied to nursing homes in 
Minnesota. 
Since the 1970s, the state has required that facilities supply 2.0 hprd. In 
1983, the state's move to case-mix reimbursement for nursing homes was 
accompanied by a regulatory change requiring 0.95 hours per standardized resident day 
(hpsrd);4 this new standard was designed to take into account residents' case 
mix. Facilities had to meet 2.0 hprd or 0.95 hpsrd, which ever was greater. 
Implementation of the 0.95 hpsrd requirement and reimbursement system occurred 
in 1985. The third set of requirements is the federal and state standards 
requiring sufficient staffing to meet residents' needs... 

"The state determined whether a facility met the 0.95 hpsrd by using a 
complex series of calculations that took into account individual residents' case 
mix, the number of residents in a facility by case-mix class, and the number of 
productive hours of nursing care each facility provided. A provider association 
stated, but state officials did not confirm, that the average facility 
provided 1.2 hpsrd, which translated to about 3.0 direct care hours per resident 
day. Waivers of the state staffing ratios were not permitted because the ratios 
were considered a minimum 

"The state eliminated the 0.95 hpsrd in 2001 and retained the 2.0 hprd, as it 
moved to a new case-mix reimbursement system with 34 case-mix levels. The 
state made this move because providers complained about having to do two 
assessments--one for the old case-mix system and the MDS, which is required by federal 
rules..." 

-Doug Mann, King Field, 8th ward
Minneapolis City Council Candidate
http://educationright.com/blog