Nursing Homes Continue to Provide Substandard Care

Increased infections, hospitalizations and overuse of medications in nursing homes are often attributed to lack of staff to provide quality care.

In the spring of 2022, President Biden announced new federal reforms to improve substandard care plaguing nursing homes across the nation. Their hope is to improve care for more than 1.4 million Medicare and Medicaid recipients, who currently reside in nursing homes throughout the country. Minimum staffing ratios, increased accountability, and public transparency are top priority. But these increased measures may not be enough to ensure residents receive adequate care. Industry leaders contend that the federal plan does not address what is truly to blame. Continued fallout from Covid-19, high staff turnover rates and a lack of funds to increase employee ratios are what they attribute to the cause of poor care. 

The Department of Health and Human Services’ Centers for Medicare and Medicaid Services is charged with overseeing 15,500 nursing homes. These facilities receive tens of billions of federal government monies each year. The department initiated their reforms in response to the pandemic, as nursing home residents accounted for nearly 25% of all Covid-19 deaths in the United States. Their untimely deaths brought poor resident care practices into public light.

An Overview of Federal Reforms

A nursing shortage is projected to worsen in the United States.

The plan outlines several initiatives designed to address substandard care practices to protect resident health. Minimum staffing requirements, phasing out shared rooms , and enhancing requirements for emergency preparedness are measures to reduce risk of infection for residents. Majority of proposed funding for the program will go toward beefing up health and safety inspections. Increased transparency of corporate ownership may help families to better vet choices for family members.

Increased inspections, financial penalties and tougher violation enforcements are also a priority in the plan. Once the plan is implemented, facilities that do not immediately seek to rectify staff shortages or improve services deemed as unsafe will risk being cut off from taxpayer dollars.

Improving Substandard Care Requires Funding

The American Health Care Association notes that without federal dollars to back it up, the plan falls short of its goal to improve substandard care. Staffing shortages have worsened since the pandemic. Plus, facilities continue to fall short of funds needed to hire and retain additional candidates to meet resident demands. Holly Harmon, RN, AHCA’s senior vice president of quality, regulatory and clinical services states, “Every nursing home wants to hire and develop more caregivers, but they can’t do it alone. An enforcement approach will not solve this long-term care labor crisis.” The association estimates a cost of $10 billion annually will be needed for nursing homes to meet additional staffing requirements.

A Lack of Staff Equals A Lack of Quality Care

According to the Bureau of Labor Statistics, nursing homes have lost 238,000 caregivers since the beginning of the pandemic.

A staffing shortage can further cause an increase in infections, hospitalizations, and overmedication for residents. A recent USA Today article reveals that understaffing violations were a known cause of similar incidents in nursing homes well before Covid-19 struck. However, very little has been done to enforce staff to patient ratios to improve care.

Hospitals, medical centers, healthcare facilities, and homecare agencies are currently experiencing a nationwide nursing shortage. This shortage is predicted to worsen. And a pandemic-fueled scarcity of home health aides is also to blame for poor patient care, according to a recent CNN report. This historic staffing crisis coupled with overworked staff and high turnover rates continue to foster substandard care for residents.

These newly proposed federal reforms will not be enforced for some time. The U.S. Department of Health and Human Services Office of Inspector General continues to audit, evaluate, and inspect nursing homes for substandard care practices based on current guidelines. And several states have already increased their staffing requirements in an effort to improve care.