Nursing Home Staff Shortages and Quality of Care

Nursing Home Staff Shortages and Quality of Care
  • A new survey reports that nearly three-fourths of nursing homes are facing staffing shortages.
  • Experts say this is resulting in subpar care for many older adults living in these facilities.
  • Experts advise family members to check out nursing homes by looking at websites that grade facilities and visiting the home in person beforehand.

The plight of nursing homes in the United States, from the lack of proper care to underpaid employees to poor working conditions, is an ongoing saga. The nursing home industry has been engulfed with these for decades, dating back to the 1980s.

However, since the COVID-19 pandemic began in 2020, experts say things have gone from bad to worse.

A new survey from the American Health Care Association reports that 98 percent of nursing home operators are having trouble hiring qualified workers. And 73 percent are facing staffing issues that could force them to close.

Additionally, nurses, nurse aides, and others who work in nursing homes remain chronically underpaid, experts say, and many residents are simply not getting the care they need.

R. Tamara Konetzka, PhD, a professor of public health in the department of public health sciences at the University of Chicago Biosciences, told Healthline that the nursing home situation is a perfect storm with multiple issues colliding.

“We have had this challenge for decades. Nursing homes have been understaffed since the 1980s,” Konetzka said. “No one has found a great solution. Each one of the problems are connected. And the industry is dependent on Medicaid, and those rates are low, about 200 dollars a day to take care of some pretty sick residents.”

Follow the money

Charlene Harrington, RN, PhD, FAAN, a professor emeritus in social behavioral sciences at the University of California San Francisco, has studied nursing homes for 40 years.

She said the biggest problem is that some of the corporate owners of nursing homes are driven by profits rather than compassion.

“Many privately owned nursing home corporations routinely release information to the public about how they are allegedly in dire financial straits and cannot afford to hire any more workers, but the truth is they have all kinds of money, especially since 2020, the first year of the pandemic,” Harrington said.

A recent studyTrusted Source published by JAMA Health Forum reported that residents in nursing homes acquired by private equity firms were more than 11 percent more likely to have a preventable emergency department visit and nearly 9 percent more likely to experience a preventable hospitalization, when compared to residents of for-profit nursing homes not associated with private equity.

Another study from the Americans for Financial Reform Education Fund showed that in New Jersey, private equity-backed nursing homes’ COVID-19 infection rate and death rate were 30 percent and 40 percent above statewide averages.

“The entire nursing home industry has long failed residents, families, and workers,” the researchers wrote. “Prior to [the COVID-19 pandemic], the deadly and dehumanizing flaws were often hidden from public view, but the pandemic has exposed the chronic understaffing, poverty wages, and inadequate regulatory oversight and enforcement that has led to a tidal wave of infections and deaths at U.S. nursing homes.”

The study concluded, “The nation invests too few resources in providing care to our most frail and vulnerable neighbors in nursing homes or in a broader range of caregiving services in the community.”

What can families do?

Patricia McGinnis, co-founder and executive director of California Advocates for Nursing Home Reform (CANHR) is an attorney and former teacher who’s been involved with long-term care reform issues for more than 30 years.

She said that while not all corporate-owned nursing homes are bad, the best thing for family members to do before deciding on a nursing home for a loved one is to visit the Centers for Medicare and Medicaid (CMS) website and read it closely.

“Every nursing home in every state is on that website, and each one has a rating for consumers from 1 to 5, with 5 being the best. Avoid the ones that are 1 or 2,” she told Healthline.

McGinnis said that one of the problems with the nursing home industry is that residents and their families often don’t speak out.

“They’re afraid of retaliation and, if they are looking for a facility, they are afraid they won’t get a placement,” she said.

Joy Loverde, a mature market business consultant and author of such books as Who Will Take Care of Me When I’m Old and The Complete Eldercare Planner, said that it’s important when searching for the right nursing home to go there in person whenever possible.

“You’ve got to see it or yourself,” she told Healthline. “Once you are there, ask them how they protect the residents and staff, how often they screen for COVID, and look any documents over with an attorney before signing anything.”

“Then ask them what their position is on having security cameras installed in the room,” Loverde added. “The good ones will say ‘be my guest,’ but the other ones will say they just don’t know. If they answer that way, just walk away.”

President Biden’s plan

As part of his State of the Union address in February, President Joe Biden announced several nursing home reforms including better oversight, minimum staffing standards, and more transparency in terms of where the money goes.

In a fact sheet that accompanied his speech, Biden said the reforms will ensure that:

* Every nursing home provides a sufficient number of employees who are adequately trained to provide high-quality care.

* Poorly performing nursing homes are held accountable for improper and unsafe care and immediately improve their services or are cut off from taxpayer dollars.

* The public has better information about nursing home conditions so that they can find the best available options.

“The Biden-Harris Administration announced new steps by Department of Health & Human Services (HHS) through its Centers for Medicare & Medicaid Services (CMS), to improve the quality and safety of nursing homes, to protect vulnerable residents and the health care heroes who care for them, and to crack down on bad actors,” administration officials wrote.

No word yet on when these reforms will begin.

Author: Thavocalist

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