Pandemic underscores systemically low staffing in nursing homes

Even with restrictions on visitors, COVID-19 has run through nursing facilities like wildfire. As we discussed recently on this blog, the Centers for Medicare & Medicaid Services (CMS) estimates that almost 26,000 residents of American nursing homes have died from COVID-19 and another 60,000 have become sick.

The CMS recognizes, however, that these numbers are incomplete. Only about 80% of nursing homes have reported their COVID-19 numbers.

Now, Reuters has released a major investigation into the problems nursing home residents are facing, and it found widespread understaffing among U.S. nursing homes. About a quarter of all nursing homes that responded to a federal survey reported staffing shortages during the last two weeks of May, Reuters found.

The staffing shortages are chronic and historical. For example, Reuters found that approximately 70% of U.S. nursing homes would fail to meet the requirements for staffing levels put into place in California — and experts advocate for more staffing than California requires.

Workers are disillusioned and underpaid

Pay for workers at skilled nursing facilities can be as low as $11, and working conditions are generally poor. This leaves many staff disillusioned — then COVID-19 added fear to the mix. As a result, Reuters found many nursing homes deliberately downplayed the seriousness of outbreaks at their homes to avoid losing even more staff. In at least four facilities, managers pressured sick workers to come in anyway.

At one nursing home, sick or absent staff left dangerous conditions in place. A single teenage trainee was left to care alone for almost 30 patients with dementia for at least part of a shift.

The work is hard and tiring. Many patients are incontinent and need help bathing and eating. Yet at another home, the majority of the staff of nurses and nursing assistants have left since April, leaving the patients without enough staff for basic safety.

Among those workers left, many are routinely working 80-90-hour weeks now, Reuters found.

Sometimes, the pandemic simply overwhelmed an already stressed staffing system. In others, the facilities’ responses to the outbreak made the situation worse. When patients and staff got sick, some managers didn’t take it seriously and even ordered staff to remove any masks they had brought from home. When staff did get sick, they were still asked to work.

The Reuters investigation details the events at several specific nursing homes, and we recommend reading the entire report. Meanwhile, now is the time to take extra care for your loved ones in nursing homes. Staffing shortages and high turnover in the industry are chronic, but the issues are especially acute during the pandemic.

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