Facilities News Spotlight

2024-06-04 Spotlight: Caring for your loved ones is their business, not their concern

Caring for your loved ones is their business, not their concern
By John and Terri Hale, John and Terri Hale own The Hale Group, an Iowa-based firm advocating for high-quality nursing home care for everyone, all the time.  Contact:
*The Gazette, June 2, 2024

The Biden Administration recently finalized a rule that would require nursing homes in America to have a minimum level of staff on duty at all times.

As advocates for consumers in nursing homes and other settings for over 18 years, we see the rule as necessary, achievable, and long overdue. It will allow nursing home residents to be better served and lead better lives.

The nursing home industry has chosen to go to war over it, using all the ammunition they have to convince governors (including Iowa Gov. Kim Reynolds) and congressional members to assist them in either killing the rule or perpetually delaying it. They’ve also filed suit in federal court to block it.

We marvel that opponents of the rule choose to ignore decades of research (and common sense) showing that residents are safer and healthier when there are more staff keeping their eyes on them, helping them, talking with and comforting them. Ignoring those facts is proof of what many have come to believe about far too many in the industry: caring for your loved ones is their business, not their concern.

Here’s what the industry is saying about the rule, and our response:

The rule is unconscionable. What’s unconscionable is the nursing home industry’s failure to police itself; allowing far too many of our friends, neighbors and loved ones to be treated inhumanely, to be neglected and abused, and to die due to inadequate numbers of, or poorly trained, staff.

The new goal is unattainable. Not true. Over 50% of facilities in Iowa and across the nation already meet the minimum standard. Many more would if the industry promoted and adopted the best practices of facilities that are better staffed and provide better care.

Finding needed staff will be impossible. The industry could address this problem by looking at the reasons tens of thousands of nurses and direct care workers have left, and continue to leave, their nursing home jobs.

Remember during the COVID crisis when these employees were called “heroes?” If they were treated as such with competitive pay, benefits, training, career pathways, manageable workloads and a workplace culture that respected them, many who’ve left would return, fewer current staff would leave, and new recruits would come on board.

We can’t afford to implement the rule. An estimated $100 billion in tax dollars flow to nursing homes in the nation every year; well over $800 million of that goes to Iowa facilities.

There’s plenty of money in the system; it’s just being used for the wrong things.

Examples: Hundreds of millions of dollars are spent on the high costs of turnover — over 50% of nursing home staff leave annually. More millions are spent to pay exorbitant fees to temporary agencies for staff to fill-in for those who have left. Untold millions of dollars are spent on excessive salaries for industry executives and lobbyists, for stock buybacks and profit for investors. Millions more will be spent to tie the staffing rule up in the courts.

Facilities will be forced to close. Closures were occurring long before this new staffing rule. They’ve closed, and will continue to, not solely due to staff shortages, but because owners and investors aren’t happy with the profits being generated, there aren’t enough residents to justify keeping them open, people are choosing to live in assisted living facilities rather than nursing homes, and because individuals want to be served in their own homes and communities vs. an institutional setting.

It’s a one-size-fits-all approach that won’t work. The rule is a bare minimum standard that facilities are free to, and should, exceed. Child care centers have minimum staff requirements. So do airlines. The standards exist to ensure those they serve will be safe. Nursing home residents deserve no less.

If the industry is successful in killing the proposal in the courts or with the aid of boosters among governors and members of Congress (to whom they donate lots of campaign cash), where does that leave us? With more years of the status quo; with too many facilities operating with too few staff and providing inadequate, if not horrendous, care.

That’s unacceptable, and shame on the nursing home industry and its supporters for asking the public to accept it.