Asking Fewer Nurses to Do Much More
The vast majority of nursing home health care workers are certified nursing assistants (CNAs). These are the people with the lowest amount of training, and they are also the lowest-paid workers in health care. Yet these are the people tasked with the health needs of some of the most elderly and sick people in our society. The complex needs of residents can include such tasks as:
- Complex wound care
- Surgical site drains
- Total parenteral nutrition (feeding tubes)
- Assisted ventilation
- IV medications
You might expect a doctor to handle this sort of work, but in a nursing home, this work is divided among the CNAs with a certified nurse on duty to manage the CNAs. Most certified nursing assistants care for about 15 patients per shift, but that number can get much higher. In a Nurse.org article, Portia Wofford reported the results of a survey of CNAs in a private Facebook group, and she found the following patient-to nurse and patient to CNA ratios:
- 32:1 nurse and 16:1 CNA- Ohio
- 44:1 nurse and 44:2 CNA- Tennessee
- 50:2 nurse and 15:3 CNA- New York
- 66:2 nurse and 66:4 CNA- Illinois
- 50:1 nurse and 30:1 CNA- Georgia
- 60:1 nurse and 60:3-4 CNA- Nebraska
The main problem is that there are no federally mandated staffing ratios for nursing homes. The COVID disaster in nursing homes, in which some 40% of all COVID deaths occurred in the U.S., created renewed political pressure, and a few states have begun introducing legislation to set standards.
For a free legal consultation, call 410-547-0202
The for-profit nursing home industry in America is aware that it is endangering the lives of residents with low staffing levels. In a for-profit business model, the key to higher profits is to raise revenue to what the market can bear and to keep costs as low as possible. In the for-profit world of nursing homes, the revenues are fixed because most of the funding comes from the government through the Centers for Medicaid and Medicare (CMS). So with prices basically set in stone, the way that nursing homes drive higher profits is by skimping on the cost of delivery, namely by slashing staffing costs to the bare minimum. Aside from the threat of fines and lawsuits, they have no financial incentive to make their nursing homes safer with more and better trained staff. In California, they tried paying nursing homes more in 2006, and the money did not make it to the staff, so while the nursing homes became more profitable, there was no increase in quality.
“The for-profit health care model is an inherent failure, and the dismal history of the for-profit nursing home industry is proof,” said Brian Brown, a founding partner with Brown & Barron.
To learn more about your legal rights and options, contact Brown & Barron’s Baltimore attorneys online or at (410) 547-0202 for a free consultation.
Contact Brown & Barron online today to schedule a free case review.