“Infinity and beyond” may be a rallying cry for Buzz Lightyear, yet when it comes to staffing and the welfare of the elderly and disabled in nursing homes. the system in our country is going backward. House Bill H.R. 7513, the Protecting America’s Seniors’ Access to Care Act, currently in Congress, represents a misguided legislative effort that, if enacted, would worsen the already challenging circumstances faced by our most vulnerable citizens.
H.R. 7513 effectively obstructs future initiatives aimed at establishing minimum staffing requirements in nursing homes nationwide. Consequently, already inadequate levels of care could plummet further, exposing residents to heightened risks that have their families rightfully alarmed. The bill explicitly prohibits the enforcement of any state minimum standards and impedes the implementation of federal minimum staffing requirements by the Department of Health and Human Services.
While the current administration has made promises to enhance the quality of care for nursing home residents, H.R. 7513 stands in direct contradiction to these pledges. Last year, when the Centers for Medicare & Medicaid proposed minimum staffing standards, the response was mixed. Industry groups such as the American Health Care Association/National Center for Assisted Living and Leading Age argued that the proposed standards were unrealistic and would financially burden nursing home facilities. Conversely, reaction from our organization, advocates, residents and their families contended that the recommendations fail to sufficiently address pressing issues.
Substantial public opposition, as evidenced by over 40,000 letters submitted during the comment period, underscores the gravity of the situation. Clearly, staffing in nursing homes is an issue of significant concern to people across the nation that merits immediate attention. It is unacceptable for individuals to suffer due to inadequate staffing and enduring deplorable conditions such as being left in soiled garments simply due to a lack of onsite caregivers.
The true impact of staffing shortages
In Fall 2023, the National Consumer Voice conducted interviews with more than 120 nursing home residents, seeking their perspectives on staffing and its impact on their lives. The results, released on March 5, 2024, report an overwhelming 88% of residents indicated that their facilities lacked the necessary staff to meet residents’ needs adequately. Additionally, 87% reported that understaffing affects them on a daily or weekly basis.
For many nursing home residents, daily medication is a necessity. When asked about the timeliness of medication administration, over 58% of respondents stated they did not receive their medication on time. Among them, 56% reported receiving their medication late several times a week, while 24% experienced delays daily. Reasons cited for these delays included a shortage of available staff and inconsistent staffing levels.
Basic activities such as showering, bathing and toileting should be integral parts of a resident’s day, affording them some sense of control. However, when asked if they waited longer than desired to shower, a significant majority — 72% — responded affirmatively. Of those, 46% reported waiting longer than desired several times a week or daily. Many respondents cited staffing shortages or untrained personnel as reasons for missed showers, with several reporting being assigned specific shower days but not consistently receiving them and some receiving showers less than once a week.
Disturbingly, 74% of respondents reported instances of neglect or harm due to understaffing, with residents experiencing falls and other medical issues because of staff shortages. Many also reported prolonged wait times for assistance via call bells, attributing these delays to overworked or under-trained staff. These findings underscore the urgent need for comprehensive reform in nursing home staffing practices to ensure the well-being and dignity of our elderly population.
As it stands, H.R. 7513 does nothing to alleviate these concerns and enhance the daily lives of nursing home residents. History has repeatedly demonstrated that we cannot rely solely on the goodwill of nursing home proprietors and operators to prioritize the well-being of residents. Legislative measures like HR. 7513 only reinforce this reality, underscoring the urgent necessity for substantive reform that prioritizes the dignity and care of our elderly population. As a society, we must strive for better.
Carrie Leljedal is a family advocate, program manager for the The Live Oak Project, a board member with Gray Panthers NYC and a spokesperson for the Illinois Caregivers for Compromise.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
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