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Study: Large Disparity in Care Between White and Minority Nursing Homes

Garcia & Artigliere

There is a noticeable difference in the amount of registered nurse care between majority-white and majority-minority nursing homes in the U.S., according to an investigation by the nonprofit Center for Public Integrity.

The Center spent some time exploring the public website Nursing Home Compare, which is promoted by the government for nursing home facility comparison shopping. Nursing homes self-report their staffing figures to the site two weeks before the annual nursing home quality survey. Often these numbers are bolstered temporarily just before the survey.

The Center then compared data found on the site to Medicare cost reports, which are filed by nursing homes and often a more accurate description of activity. The Centers for Medicare and Medicaid Services, the federal agency overseeing nursing home facilities, stated in 2005 that Medicaid cost reports, which contain information similar to that found on Medicare cost reports, contain more accurate data than quality surveys conducted by state surveyors.

What they found was that the numbers for daily staffing levels, especially in the case of registered nurses, were quite a bit lower in the Medicare cost reports. Additionally, registered nurse staffing levels were even lower for majority-black and majority-Hispanic nursing homes. The gap was larger overall for minority nursing home care.

The Center found that:

  • Nursing Home Compare reported that registered nurses administered about a half-hour of care per day at majority-black nursing homes. However, Medicare cost reports claimed it was more like 20 minutes a day.
  • The staffing gap was even worse for majority-Hispanic nursing homes (where more than half of residents are Hispanic). Majority-white nursing homes have 60 percent higher daily average registered nurse staffing levels than majority-Hispanic nursing homes. White-majority homes had a 34 percent higher staffing rate than black-majority nursing homes, according to the Center’s investigation.
  • Low registered nurse staffing levels were notable in black-majority facilities in the Midwest, such as Wisconsin, Illinois, and Michigan.
  • El Paso and Brownsville in Texas had daily registered nurse care levels at only about 10 minutes per resident for majority-Hispanic homes.
  • Even when residents were equally sick or poor, the white-majority nursing homes had better registered nurse care than majority-black or majority-Hispanic facilities.

It’s important to note that quality of care is often determined by the amount of registered nurse care provided at a facility. Registered nurses (RNs) have the training and credentials to assess health and make decisions regarding care. Having an RN at a facility 24/7 will help ensure that medical crises will be handled or averted.

It should be noted that Title VI of the Civil Rights Act of 1964 and other anti-discrimination laws cover any discrimination issues (i.e., race, color, and national origin) regarding quality and levels of staffing in federally funded nursing home facilities.

If you believe a loved one has been the victim of nursing home abuse due to discrimination and lack of quality care, please contact the elder abuse attorneys at Garcia & Artigliere. Our national law firm represents victims of elder abuse and nursing home abuse against skilled nursing facilities, nursing homes and assisted living homes.


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