Several expert witnesses called for the federal government to address inadequate staffing at nursing homes and long-term care facilities in wake of the coronavirus pandemic and its fatal toll on residents and workers. 

“The issues that COVID-19 exploited are not highly technical or complex. They are basic issues of training and adequate staffing,” testified Nicole Howell, executive director for Ombudsman Services of Contra Costa and Solano Counties. “Poor staffing in long-term care facilities was the gasoline to COVID-19’s match.” 

Her testimony came during a Thursday hearing held by the House Ways & Means Committee during a hearing Thursday afternoon. The hearing centered around the impact of the coronavirus crisis on nursing homes. 

Howell also explained that “within the long-term care industry, direct care workers on average earn only $1 to $2 more per hour over state minimum wage, forcing these dedicated people to work 60 to 80 hours per week at multiple locations.” 

“Meaning you can have a caregiver that works at one facility where there are active COVID-19 infections who are forced to work at a second location and may transmit the virus to residents,” she added. 

McKnight's Long-Term Care News, December 2018, Resident Care, David Grabowski
David Grabowski, Ph.D.

David Grabowski, Ph.D., Harvard professor and healthcare policy expert, also stressed the need for providing more resources, such as better wages and more personal protective equipment, to address staffing shortages. 

“Staff are frightened given the lack of COVID testing and PPE, and for good reason,” he said. “New federal COVID data suggests that over 500 staff nationally have died from COVID — making nursing home caregiver the most dangerous job right now in America, with a higher death rate than logging workers and commercial fisherman.”

He also emphasized the need for regular testing in nursing facilities and called on the federal government to develop a consistent testing and PPE policies nationwide, and provide resources for facilities to meet those standards.  

“Until we get rapid and accurate testing for all staff and residents, we won’t be able to contain COVID. Rather than pushing the logistics and costs of testing and PPE to states and nursing homes, the federal government needs to take ownership of this issue,” Grabowski said. 

“If we had testing and PPE in place, we would be able to move safely towards opening nursing homes again to family members,” he added. 

The pandemic’s toll on nursing homes is a “deadly consequence” of inadequate staffing levels and lax infection control practices, according to Toby Edelman, senior policy attorney for the Center for Medicare Advocacy. She added that CMS must establish and enforce stronger oversight measures. 

“The coronavirus pandemic has made all too visible the lethal consequences of poor care and no oversight. We can and must learn from what has gone wrong, and do better in the future,” Edelman said.

Read additional coverage of the hearing from McKnight’s Senior Living.