Make your own free website on

Doug Mann LPN, LNC

Nursing homes / Vets' Home 2

Home | Consumer Information | Resume | Education advocacy | Writings | Links | Nursing | Nursing Homes | French & Spanish | Modern Greek | Mann for School Board in 2008

Vets' Home noncompliant with direct care staffing rules,
according to a federal report

from Doug Mann's blog
2 Sept 2005

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 Department regulations. No MN nursing home may legally provide less than 2 hours of direct nursing care per resident day, according to a federal HHS report dated November 2003.

However, the defacto minimum has been 0.95 hours per resident day (hprd). I filed, and attempted to file complaints with the Health Department about understaffing at nursing homes during the 1990s. [When seeking information about minimum staffing requirements] I was always told that nursing homes are not considered "understaffed" on the basis of staffing patterns alone unless nurse aide staffing levels fell below 0.95 hours 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 Department of Health regulations. (I would be surprised if any MN nursing home is in compliance with minimum staffing rules.)

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 2.0 hours per resident day or 0.95 hours per **standardized resident day,** whichever is greater [presumably in facilities licensed to provide "skilled care"], according to the report cited below.

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

"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..."

 Vets' Home 1 / Vets'Home 2