As a former Center for Medicare and Medicaid Services (CMS) manager with responsibilities for ensuring the quality of care in our nation’s nursing homes, I take exception with your recent commentator (CDN, April 7, 2024) urging people to write our U.S. senators to oppose implementation of national nurse staffing standards.
CMS proposed these standards in September 2023 and received more than 40,000 public comments. CMS will likely not finalize its proposals until fall 2024. For this reason, I suggest your readers review nursing facility resident advocates’ comments on these minimum staffing standards (see www.nursinghome411.org/comment-excerpts-min-staffing). And if you have a loved one living in a nursing facility, write your congressmen to support CMS proposals.
You will also see that many, if not most, nursing facility advocates view these standards as too modest!
With great and relentless opposition from the predominantly for-profit nursing home industry, advocates have worked for more than 30 years (believe it or not) to establish these standards. As of 2021, roughly 70% of U.S. nursing homes were for-profit facilities. This includes those owned by private equity firms, which comprised 11% of all nursing homes.
By keeping staffing at minimally adequate levels so as to meet, but not exceed, quality-of-care resident outcomes (while paying low salaries; the median hourly wage for a certified nursing assistant in Bellingham was $19.52 in August 2023), investor profits increase.
As suggested by your commentator, positive policy and program change might occur from enacting new legislation. However, the reality is that the most critical indicator of a nursing home’s quality is the amount of nursing care, especially the amount of LPN and nursing aide staff time provided to one’s loved ones on a daily basis.
In making the difficult decision about nursing home placement it is critical that family members ask facility administrators about their registered nurse, LPN, and aide staffing levels, and the extent of staff turnover. In this regard, CMS publishes, for every certified nursing facility in the country, a performance rating system that includes analysis of nurse staffing levels.
If you are making a decision about nursing home placement and have a choice about where your loved one should live, it is suggested that you review these data at Nursing Home Compare (see www.medicare.gov/care-compare/?providerType=NursingHome).
Please consider that these standards are much less about what the commentator observes as impacts on rehabilitation care patients discharged to skilled nursing facilities from PeaceHealth St. Joseph Medical Center and much more about whether a nursing assistant is available when your loved one needs to use the bathroom before they soil themselves, whether they are fed on time, and are treated with dignity and respect in managing their physical decline and dementia.
The extensive use of antipsychotic medications in nursing homes as “chemical restraints” is doubtless related to lower staffing. Contrary to the commentator, back this dedicated workforce by supporting these proposed standards. Support resident-centered, rather than corporate-centered, care.
Guest commentary author Alan Friedlob lives in Birch Bay.
Commentary response: Nursing-home staffing mandates critical to dignified care
Tell Senators: Support resident-centered, not corporate-centered, care
As a former Center for Medicare and Medicaid Services (CMS) manager with responsibilities for ensuring the quality of care in our nation’s nursing homes, I take exception with your recent commentator (CDN, April 7, 2024) urging people to write our U.S. senators to oppose implementation of national nurse staffing standards.
CMS proposed these standards in September 2023 and received more than 40,000 public comments. CMS will likely not finalize its proposals until fall 2024. For this reason, I suggest your readers review nursing facility resident advocates’ comments on these minimum staffing standards (see www.nursinghome411.org/comment-excerpts-min-staffing). And if you have a loved one living in a nursing facility, write your congressmen to support CMS proposals.
You will also see that many, if not most, nursing facility advocates view these standards as too modest!
With great and relentless opposition from the predominantly for-profit nursing home industry, advocates have worked for more than 30 years (believe it or not) to establish these standards. As of 2021, roughly 70% of U.S. nursing homes were for-profit facilities. This includes those owned by private equity firms, which comprised 11% of all nursing homes.
By keeping staffing at minimally adequate levels so as to meet, but not exceed, quality-of-care resident outcomes (while paying low salaries; the median hourly wage for a certified nursing assistant in Bellingham was $19.52 in August 2023), investor profits increase.
As suggested by your commentator, positive policy and program change might occur from enacting new legislation. However, the reality is that the most critical indicator of a nursing home’s quality is the amount of nursing care, especially the amount of LPN and nursing aide staff time provided to one’s loved ones on a daily basis.
In making the difficult decision about nursing home placement it is critical that family members ask facility administrators about their registered nurse, LPN, and aide staffing levels, and the extent of staff turnover. In this regard, CMS publishes, for every certified nursing facility in the country, a performance rating system that includes analysis of nurse staffing levels.
If you are making a decision about nursing home placement and have a choice about where your loved one should live, it is suggested that you review these data at Nursing Home Compare (see www.medicare.gov/care-compare/?providerType=NursingHome).
Please consider that these standards are much less about what the commentator observes as impacts on rehabilitation care patients discharged to skilled nursing facilities from PeaceHealth St. Joseph Medical Center and much more about whether a nursing assistant is available when your loved one needs to use the bathroom before they soil themselves, whether they are fed on time, and are treated with dignity and respect in managing their physical decline and dementia.
The extensive use of antipsychotic medications in nursing homes as “chemical restraints” is doubtless related to lower staffing. Contrary to the commentator, back this dedicated workforce by supporting these proposed standards. Support resident-centered, rather than corporate-centered, care.
Guest commentary author Alan Friedlob lives in Birch Bay.
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