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Extraordinarily high turnover among staffs at nursing homes likely contributed to the shocking number of deaths at the facilities during the pandemic, the authors of a new study suggested. The study, which was published Monday in Health Affairs, a health policy journal, represents a comprehensive look at the turnover rates in 15,645 nursing homes across the country, accounting for nearly all of the facilities certified by the federal government. The researchers found the average annual rate was 128 percent, with some facilities experiencing turnover that exceeded 300 percent. (Abelson, 3/1)

Nurses working in nursing homes saw an average turnover rate of greater than 100% in a given year, according to a study released today in Health Affairs. While the rates by position varied, the averages were all above 100%: registered nurses, 140.7%; licensed practical nurses, 114.1%; and certified nursing assistant, according to the report. Ashvin Gandhi, assistant professor at UCLA Anderson School of Management and one of the report's authors, characterized the staffing turnover rates as "alarmingly high, higher than most people would have expected." (Christ, 3/1)

A nursing home accused of illegally “dumping” patients onto city streets and into ill-equipped homes in order to take in more lucrative COVID-19 patients will nearly double its nursing staff, allow increased oversight and pay $275,000 in penalties and costs to settle a lawsuit brought by the Los Angeles city attorney’s office. City Atty. Mike Feuer on Monday announced the legal agreement with the Lakeview Terrace skilled nursing facility, which he had accused of “sustained” and “intentional” misconduct in failing to adequately tend to some patients, while pushing others out of the 99-bed home. (Rainey, 3/1)

A report released Monday by advocates for the mentally ill said a delayed response to the coronavirus at the District’s public psychiatric hospital contributed to the deaths of 17 patients and one staff member in the past year. St. Elizabeths Hospital, D.C.’s 166-year-old mental hospital in Southeast Washington, houses patients committed in civil and criminal proceedings. Although it once held thousands of patients, its population has dwindled to about 200 as fewer people have been committed by courts in recent decades and as officials have tried to keep patients out of congregant settings during the pandemic. (Moyer, 3/1)

Only a few months after CMS massively changed how skilled nursing facilities are reimbursed for therapy services, the pandemic hit and threw long-term care operations into a tailspin. That makes it difficult to determine exactly how the change affected therapy services and therapists in nursing homes, researchers say. A report published in Health Affairs on Monday shows that therapist staffing levels were cut in anticipation of and after the change to the patient-driven payment model in October 2019. The new model replaced the long-standing Resource Utilization Group payment system, known as RUG, with general support from the post-acute care industry. But, after the fourth quarter of 2019, there isn't reliable data to further track the changes, the authors said. (Christ, 3/1)

KHN: Sorting Out How Politics, Policies Figure In Flap Over New York Nursing Home Covid Death Rates 

The plaudits have faded for New York Gov. Andrew Cuomo. Once hailed as a paragon of pandemic governing, he’s since come under scorching criticism for undercounting the state’s covid deaths among nursing home residents by as much as half. The tallying flap drew attention to another misstep: a policy last March that directed nursing homes to accept covid-positive patients from hospitals, potentially exposing high-risk, medically vulnerable nursing home residents to the deadly virus. Did the governor intentionally fudge nursing home death counts to deflect attention from the impact of an ill-advised directive? That depends on whom you ask. (Andrews, 3/2)