We Need Staff Mandates in Our Nation’s Nursing Homes
A recent article in the Washington Post highlights the sad state of our country’s nursing homes and why the White House needs to take action. Nursing home advocates, experts, and families have been asking for minimum staffing requirements for years in order to provide better care for residents. Now, with the coronavirus taking a very public and tragic toll on nursing homes, it’s even more important the current administration sets forth a federal minimum staffing mandate as soon as possible.
According to the Washington Post, “the Biden administration has set in motion plans for a federal minimum staffing requirement for the nation’s 15,500 nursing homes. The new rule is expected to be announced in 2023.”
Nursing homes have struggled with appropriate staffing levels for decades. A 2020 study from Health Services Insights discusses how to determine whether a facility has adequate nurse staffing, noting “most nursing homes do not provide sufficient staffing to ensure basic quality.” Per federal regulations:
The facility must have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable level of physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity and diagnoses of the facility’s resident population in accordance with the facility assessment . . . (see 42 C.F.R. § 483.70(e)).
The study offers recommendations on staffing and meeting current federal requirements, noting that keeping nursing levels low results in negative outcomes: “Inadequate staffing levels can have devasting consequences as found in California nursing homes with COVID-19 that had 25% lower RN staffing levels than homes without non-COVID-19 residents.”
Researchers conclude that nursing homes must comply with federal staffing requirements and provide adequate staff for residents, or residents could suffer serious injury.
Staff shortages cause nursing home residents to suffer
The Washington Post details the story of Louie Sira, 67, who allegedly died as a result of short staffing at Parkview Healthcare Center in Hayward, California in 2019. His daughter described the extent of the nursing home neglect, detailing the times she found her father soaked in urine, covered in bug bites, and with a serious pressure sore on his heel.
The pressure sore eventually grew so serious due to lack of care, according to the Post, “the gangrenous wound had dug down to bone and tendon in his heel, according to court records. Doctors were forced to amputate his right leg above the knee. He died three months later, in August 2019.”
A civil court awarded Sira’s family and other plaintiffs $13.5 million after a jury found the nursing home and its management company cut down on staffing in order to increase their profits. Authorities are also seeking additional civil penalties. The facility is appealing the verdict and denies the allegations.
Protecting our senior citizens through federal reform
In early 2022, President Biden announced a series of reforms to improve the safety and quality of our nation’s nursing homes, aimed at providing senior citizens with proper and meaningful care. These reforms will ensure that:
- “every nursing home provides a sufficient number of staff 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; and
- the public has better information about nursing home conditions so that they can find the best available options.”
The formal mandate is expected sometime in 2023, but the nursing home industry is already pushing back, contending “minimum staff mandates of 4.1 hours per resident per day would cost up to $10 billion per year and are unworkable because of a shortage of workers willing to do the job.”
Mark Parkinson, president and chief executive of the American Health Care Association, which represents the nursing home industry, said to the Post, “It’s one thing to announce we are going to get all these workers in all these buildings, but are we as a society willing to pay for it? So far the answer has been no.”
Why is there a nursing home staff shortage?
A CNN report from June 2021 described the devastating consequences of COVID-19 and staffing shortages in nursing homes across the country. With 132,000 residents and 1,900 staff dying during the pandemic, people took notice of what experts call a “decades-old problem.” In fact, Charlene Harrington, a professor emerita at the University of California, told CNN, “Seventy-five percent of the nursing homes had inadequate staffing before the pandemic started. It’s not surprising that they weren’t able to cope with it.”
Two years after the pandemic began, the staffing crisis remains.
What happens to patients when nursing homes are understaffed?
Staff shortages are one of the major causes of nursing home abuse and neglect. The chance for neglect increases as the patient to staff ratio increases and patients must wait longer and longer to receive attention and care. Understaffing can lead to patients and residents experiencing:
- Not receiving their medication on time (or at all)
- Bedsores and infections
- Deterioration in hygiene
- Deterioration in physical and/or mental condition
- Falls from wheelchairs or beds
- Malnutrition and dehydration
- Physical and sexual abuse
- Depression from lack of social interaction
- Catastrophic injuries
- Wrongful death
If a nursing home is having trouble retaining nursing staff and personnel, they may turn to unqualified, untrained, and unvetted staff instead, which can be devastating to your loved one. If you suspect your loved one is experiencing abuse or neglect – or if you’re looking for a nursing home for your loved one – look for these red flags and then talk to an experienced Richmond attorney:
- Is it difficult to find staff? Does the facility and common areas look empty?
- Does the staff seem overworked, harried, exhausted?
- Do residents appear sad, anxious, or in need of help?
- Are the residents in clean clothes, with clean linens?
- Is the facility overall well-maintained and clean? Do any areas look unsafe or in disrepair?
- Has your loved one said their complaints are being ignored?
If the answer to any of these is “yes,” you should take the warning signs seriously. If your loved one is experiencing abuse or neglect in a nursing home, you should call a lawyer immediately. At Phelan Petty, we can help. To set up a free consultation, call our office in Richmond or fill out our contact form today. Proudly serving Virginia.
Related Content
- Nursing Homes and Medicare: Higher Needs Equals Higher Reimbursement
- Nursing Home Neglect and Abuse: Learn How to Protect Your Loved Ones
- Private Equity, Nursing Homes, and Decline in Care: The Connection
