For yers we have heard complaints from family members: The staffing levels are too low at nursing homes. Yet, the records showed that the mandated levels were being met. The mystery is now solved, and the truth shows gaming.
All it took was Medicare comparing payroll records with claimed staffing levels. The two did not match. The amount paid and the number of staff members claimed as on duty were just not the same.
As a result, Medicare has downgraded 1 in every 11 nursing homes (about 1,400) have been downgraded from their Medicare star levels (5 is highest and 1 is lowest. As a result, 1,387 nursing homes of the 15,616 skilled nursing facility have only one-star ratings. The downgrades came when the facilities could not verify their reported staffing levels with pay records or refused to provide the pay records. Some facilities have argued that they had managers working overtime to meet the standards for staffing. That kind of information is difficult to generate and is based on a he said/she said scenario. And there are few records on management participation.