The Biden administration has said it will set a staffing ratio requirement for nursing homes
“Our mission aligns with the goals of the Biden administration,” said Tony Marshall, president of the Georgia Health Care Association, a nursing home industry advocacy group. “However, we have serious concerns about the administration’s plans to implement new staffing requirements without prioritizing resources and funding to ensure nursing homes are able to meet these requirements. “
Research has shown a history of problems in nursing homes, where patients are not always physically or mentally able to defend themselves if care is inadequate.
The situation was a ripe setup for the COVID-19 pandemic to wreak even more havoc among elderly residents. Well over 3,000 nursing home residents in Georgia have died of COVID-19.
Biden acknowledged the alarm, saying in his speech, “As Wall Street corporations take over more nursing homes, the quality of those homes has gone down and costs have gone up. It ends on my watch.
It was unclear, however, what power Biden had to end it. Much of the tension relates to a widely acknowledged shortage of skilled healthcare workers.
Labor shortages already existed before the pandemic and have only worsened as burnout and stress have caused many to leave the profession. Those who stayed, especially registered nurses, often found they could make a lot more money by quitting their usual jobs and returning to work through temp agencies. Hospitals and nursing homes say agencies have in many cases not increased the supply of workers, but simply retrained them at higher costs.
Care home representatives have suggested that giving them enough money to pay workers more would allow them to increase their workforce. But retirement homes are not always cash cows.
Biden highlighted the role of private equity in the quality of retirement homes.
His proposal does not appear to relate to paid elder care such as assisted living facilities and large personal care homes. A 2019 Atlanta Journal-Constitution investigation found widespread problems in these homes, including insufficient oversight and profit-minded management, that caused devastating harm to patients and residents. While many facilities work to provide decent care, AJC has learned from whistleblowers and court records of numerous cases where understaffing has led to neglect, inadequate care, harm to patients, and even the death.
But some of the survey’s findings are relevant to federally regulated nursing homes.
The AJC found that investors had rushed into aged care hoping to make money as residents poured in. But the windfall often did not materialize, and owners who found themselves in financial difficulty were then faced with the question of paying the right staff.
Even before the pandemic, the AJC survey found that more than 20% of assisted living communities and large personal care homes in Georgia had owners or operators who were experiencing recent financial problems.
Having enough paying patients is essential. During the pandemic, the census in Georgia’s nursing homes dropped by more than 10%, leaving more than a quarter of nursing home beds unoccupied, according to the GHCA.
Ginny Helms is president of Leading Age Georgia, which represents nonprofit retirement homes
“The real problem in my mind is that there is a personnel crisis,” she said. “And that if they really want to improve the quality of care, focusing on building staff, what we really need to do is review Medicaid rates.”
Although Medicaid is best known as the government insurance plan for low-income children and mothers in Georgia, it also pays residents of nursing homes. It’s expensive, and even though nursing home residents make up only a small number of Georgia Medicaid patients, it’s a huge chunk of fundraising expenses.
Raising payments for nursing homes would require money from federal and state coffers. It’s an open question whether lawmakers in Georgia or Congress are willing to do this.
But Biden didn’t mention that in his speech. His administration, however, said it would ask for more money for more inspectors to increase inspections.
AARP’s Jenkins applauded the notion, saying AARP “urges the federal government to move quickly to ensure minimum staffing standards, increase transparency, and hold nursing homes accountable when they don’t.” not provide quality care”. She added that “it is a national disgrace that more than 200,000 residents and staff of nursing homes and other long-term care facilities have died” in the pandemic.