Our joint investigation found that contracted hours for certified nursing assistants in nursing homes across Maine nearly doubled since 2017. And agency staffing hours across all employee types rose 66% during that same period.
These contracted traveling nurses and nursing assistants, initially intended as a stopgap during an emergency or staff shortage, are increasingly becoming the norm, according to our analysis of federal data and more than a dozen interviews with nursing home administrators, educators, staffing agencies and state officials. Experts said patient care is impacted when nurses and nursing assistants are less familiar with the patients, and that those who travel to more than one nursing home pose additional risks of transmitting COVID-19 or other infections.
The story began when the Monitor’s editor, Daniel Dinsmore, saw our story about the national crisis in nursing homes and talked to Jennifer LaFleur, IRW’s former data editor, about whether there might be a local angle for them. That first story, published with Investigate Midwest, revealed that the industry’s largest lobbying group has fought legislation to increase staff ratios and pay over the years, which contributed to the crisis many facilities faced during the height of the COVID-19 spread.
The Maine story was written by Rose Lundy, a health reporter at the Monitor, and Braeden Waddell, a former IRW data intern now on a data fellowship at U.S. News and World Report.
Lundy credits Waddell with the data analysis that helped them find a focus for the story.
“Braeden noticed these interesting number of contract hours,” she said, referring to how many nursing homes had to fill nursing and nursing assistant positions with the help of outside agencies. “Once we came across those numbers, we pivoted to concerns about staffing and staffing ratios.”
In the process of reporting on the pandemic’s many facets over the last year —from health to economic woes — Lundy said she interviewed health care workers, professors and others in health leadership positions. Many of those sources said, “We took these people for granted. We never really appreciated them.”
As a result, “I started to think there are so many more directions we could go with this,” Lundy said. “Our story is really nuanced and long and complex. But there’s so much more to explore.”