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Understaffing in Nursing Homes Creates a Serious Risk of Harm and Inequities

The COVID-19 pandemic has severely affected nursing homes and has torn the bandage off to reveal the historical problem of understaffing in those facilities.  The HSOA Journal of Gerontology and Geriatric Medicine recently published an article entitled, “Time to Ensure Sufficient Nursing Home Staffing and Eliminate Inequities in Care.”

In the article, the authors highlight the dangerous practice of understaffing in nursing home facilities. The article discusses:

  • Understaffing and High Turnover Rates Prior to the Pandemic;
  • Inequities in Nursing Homes Staffing for Racial and Ethnic Minority Residents;
  • For-Profit and Private Equity Nursing Homes Have Lower Staffing and Poor Care;
  • During the Pandemic, Low Staffing Levels Predict COVID-19 Infections;
  • Failed Nursing Home Staffing Standards
  • Federal and State Failure to Enforce Staffing Violations;
  • Dangerous Work for Staff Who Receive Low Wages and Benefits;
  • Disparities for Women and Racial and Ethnic Minority Nursing Home Staff; and
  • Policies to Ensure Adequate Staffing;

The article reveals that federal nursing home minimum staffing standards have not been updated in 30 years. Although the Nursing Home Reform Act of 1987 has been updated in 2016 by President Obama, there are no minimum standards for “competent care.” What’s worse is that federal and state agencies rarely enforce nursing home staffing violations.

In Ohio state laws arbitrarily require only 2.5 hours per patient day of combined nursing and nurse aid care.  The Cleveland Plain Dealer recently completed a study that Ohio nursing homes rank 35th amongst other states in staffing numbers. However, research has demonstrated the importance of having a minimum of 4.1 hours per patient day nursing care in order to prevent harm and jeopardy for long stay residents  These numbers have since been verified in other studies and have been endorsed by professional associations and experts.

Researchers concluded that facilities with a higher concentration of minority residents are more likely to be understaffed. Racial and ethnic minorities are almost 10 percent more likely to end up in a low-quality nursing home, especially if they’re on Medicare or Medicaid.

When it comes to for-profit and private nursing homes, they are far more likely to be understaffed and offer low-quality care. Non-profit and government nursing homes have 16 percent more staff than their private or for-profit counterparts—and when staffing is at such a premium, that 16 percent makes a huge difference.

Finally, understaffed nursing homes were more than twice as likely to see COVID-19 infections.

When it comes to the staff themselves, they are woefully underpaid. Nursing home workers are most likely to become injured, often by physically lifting and moving patients. In 2018, the average salary was just $22,200. Long hours, low benefits, heavy workloads, and low salaries mean that many workers have to work in multiple homes just to make ends meet.

The authors posit that by raising wages, setting minimum federal standards, and enforcing staff violations, most of these inequalities and abuses can be prevented.

If your loved one has been the victim of nursing home abuse, talk to an attorney as soon as possible. Call Dworken & Bernstein for a consultation today.

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