American Nursing Homes Leave Elderly to Care for Themselves

Tad Thomas, Esq. One of today’s greatest crisis is also the worst irony: nursing homes are largely without nurses.

Thirty years ago, elder justice advocates already saw this crisis brewing. In 1987, federal law intended to make it law that a nurse had to be on premises of every nursing home at least 8 hours a day. In a struggle to pass at least some regulation, this intention disappeared in compromise.

Today, the NY Times reports, nursing homes do not have a nurses present all of the time, or even most of the time. Appalled that it has taken decades for action to be taken on the problem, Representative Jan Schakowsky (D-Illinois) has introduced the bill Put a Registered Nursing in the Nursing Home Act, which would require a direct-care nurse 24 hours a day, seven days a week, in all nursing homes that receive Medicare or Medicaid reimbursement–nearly 16,000 (NY Times).

Tad Thomas, Esq.

Tad Thomas, Esq.

Currently, the number of nurses in nursing homes across the U.S. is spotty to say the least. Tennessee, Rhode Island, Hawaii and Connecticut are the only 4 that require a nurse present at all times no matter what. The other 46 states may determine nurse care by number of beds (note: not people). In New Jersey, an RN has to be present 24/7 if there are more than 150 beds. Other states have systems that theoretically cover all shifts, but it is critical to consider that this data is self-reported by staff. Reports are likely biased– in other words, care and quality nurse presence much lower. One report shows that 1,777 nursing homes (11.4 %) have no registered nurse available around the clock.

Adding to the frustration is the overwhelming evidence that the presence of a registered nurse is not only affordable, but so obviously important. The Times highlights that homes with more registered nurse care have fewer cited deficiencies by inspectors and better cared for patients. Patients given proper attention stay out of the hospital longer, suffer fewer bedsores, urinary tract infections, and catheterizations. What’s more, adequate care can save the U.S. millions of dollars in medical costs for a wise investment. Increasing RN presence is a venture that won’t break the bank, the average pay is $68,910 according to the Bureau of Labor Statistics. At the end of the day, “care is better and it costs less” (NY Times).

But like any issue, solving the nursing home crisis is not all black and white. There is concern for a shortage of RN’s, as they often go to big city hospitals with better pay instead of homes in rural areas. Other caretakers, such as nurses aides, are infamously paid poor wages that prove difficult to even live on (TLC attorney blogger, Saul Gruber, talks more about that  here). Labor costs and shortage, for any kind of nurse, are largely the main issue when it comes to fixing the system. For-profit homes make millions of dollars, but too often opt out of paying for workers and wages that will bring the proper care that the elderly population deserves. The increased presence RN’s is one of the best places to start to improve the system and keep our elderly loved ones cared for–not abandoned as communities left to save themselves when they’re hurting.

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