Shortage of Qualified Nurses Undermines Quality of Nursing Home Care

Madeleine Jones
June 3, 2016

Long-term care providers are reporting massive numbers of vacancies and high turnovers rates for nursing assistant and home health attendants. These high turnover rates undermine the quality of care provided to their residents.

Long-term care providers, after friends and family, are the largest collection of individuals that provide care for the elderly. Their importance will only increase as the U.S. population continues to age. These staffers are chronically underpaid and overworked and as a result, long-term care facilities cannot retain competent staff.

Long-Term Care Providers

There are two types of long-term care providers: nursing homes and home healthcare providers.

Nursing homes are permanent residences for the elderly. The residents are cared for by a full staff 24 hours a day. This level of care usually means that nursing homes are very expensive. They are reserved generally reserved for residents who are unable to care for themselves. Nursing homes care for residents that suffer from permanent conditions, like dementia, that undermine their ability to live alone.

Home healthcare providers administer care in the home of the resident. They send individual or teams of nursing assistants to assist residents in their own homes. These residents are semi-autonomous and relatively healthy. These nurses generally work in shifts of a few hours. Only in extreme circumstances do home healthcare providers staff homes with a nursing assistant 24 hours a day.

Both of these providers are experiencing significant shortages of qualified staff.

Underpaid and Overworked

Long-term care providers are the cornerstone in providing care for the elderly. As such, they require a workforce that is experienced and dedicated. Instead several studies have found that turnover rates are anywhere between 45 and over 100 percent. No one is ever around long enough to become an expert. Therefore, long-term care providers cannot provide the care that is required.

These workers operate in an emotionally and physically strenuous environment. They are underpaid, often little more than minimum wage. They are over-worked because of chronic staff shortages. They are, on average, less educated. They are disproportionately uninsured and reliant upon government assistance. In short, they are woefully unprepared for the rigors of providing long-term care.

The Problem

All of these factors combine into the perfect storm that leaves elderly residents victims of nursing care negligence and abuse. Many of these staffers are not malicious. They simply lack the education and training to properly care for their residents. Caring for patients, identifying dangerous symptoms and administering medication are all multi-faceted endeavors that require years of training for hospital nurses. Inadequate training all but guarantees that accidents will happen.

Moreover, residents are entirely dependent upon their long-term care provider and are unable or unwilling to speak up. This creates the perfect environment for abuse and neglect to run rampant.

How did this happen?

A major reason for this current conundrum is that society does not view nurse assistants and healthcare attendants favorably. They are looked down upon in the medical community which discourages future candidates from selecting this field.

Most people have accepted the myth that these workers are little more than maids for the elderly, that their jobs primarily consist of cleaning their residents and mopping floors. The reality is far from that. These workers administer medications, perform basic medical treatment and provide end-of-life care. They are the first responders if there is a medical emergency and often care for residents when they are post-op.

Moreover, Medicare and Medicaid account for three-fifths of long-term care provider expenditures, their policies shape the industry. These programs are primarily concerned with protecting consumer rights, rather than worker rights. The regulations only require basic entry-level training and very limited career growth. Since these programs do not emphasize these benefits then the long-term care providers do not have the budget to offer them to their employees.

There are several other problems as well. For example, welfare assistance is run by the states in block programs. Most states require that the participants obtain a job in order to access these benefits. This precludes them from applying for positions in long-term care facilities which require preliminary training. These programs lock people into accepting certain types of jobs and do not allow them the flexibility to move onto other positions that may require training.

The Solution

There are a number of solutions being debated.

  • Develop worker pools by loosening restrictions on welfare assistance to encourage them to apply and work in long-term care facilities.
  • Tie some portion of public-private reimbursement programs to employee wage and benefits – for workers who provide the actual care, not administrators.
  • Increase worker benefits.
  • Develop career ladders to encourage advancement and retention.

Most of these are limited initiatives or pilot programs. Neither the states nor the federal government have robustly addressed this growing problem. If you or a family member was seriously injured in a nursing home, contact a Las Vegas personal injury attorney at Cogburn Law Offices today for a free case consultation.