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David Grabowski Profile picture
David Grabowski
@DavidCGrabowski
Professor, Health Care Policy, Harvard Medical School -- health economics, aging, long-term care, post-acute care
Jan 9, 2024 • 5 tweets • 2 min read
🚨New @Health_Affairs paper led by @KateHJun

Staffing shortages observed during the pandemic would have been worse if not for foreign-born staff remaining in the nursing home workforce

short🧵
healthaffairs.org/doi/10.1377/hl…
Image We found number of native-born CNAs has been declining rapidly since mid-2010s, whereas number of foreign-born CNAs remained relatively constant even during the pandemic. Our results largely reflect foreign-born CNAs remaining in their jobs versus new entry to the workforce
2/ Image
Oct 28, 2023 • 11 tweets • 3 min read
🚨New @NEJM Perspective with John Bowblis 🚨

"Minimum-Staffing Rules for U.S. Nursing Homes — Opportunities and Challenges"

The proposed rule may be the biggest potential nursing home reform in decades. We offer five recommendations to improve it.
🧵 1/
nejm.org/doi/full/10.10…
Image Who staffs nursing homes?

Registered nurses (RNs), licensed practical nurses (LPNs) & certified nurse aides (CNAs) are the primary caregivers. RNs & LPNs focus on clinical tasks of resident assessment, treatment & medication mgmt, while CNAs provide bulk of hands-on care
2/
Sep 1, 2023 • 12 tweets • 3 min read
The proposed nursing home minimum staffing rule is out.

It feels good to write that. The rule is far from perfect, but it is decades overdue. Congrats to everyone that made this happen.

As you can imagine, I have thoughts!

🧵 below…
whitehouse.gov/briefing-room/… The staffing requirement is modest in my opinion. The proposed rule is 2.45 certified nurse aide (CNA) & 0.55 registered nurse (RN) hours per resident day (HPRD). A 3.0 HPRD staffing requirement is LOW

CMS asked for comment about moving to 3.48 HPRD. My comment: "yes, do it!"
2/
Aug 6, 2021 • 9 tweets • 4 min read
Two concerning facts are getting attention:

1) Only around 60% of nursing home staff are vaccinated nationally

2) After many months of decline, staff & resident COVID cases and resident COVID deaths are trending upwards

Are these potentially linked? 🧵1/ Here are the most recent vaccination numbers from the CMS NHSN website 2/
data.cms.gov/covid-19/covid…