Eugenia “Gene” Thornton is a retired U.S. Army colonel and president of the Dover chapter of the Military Officers Association of America.
Local government is best suited for local issues, like education and health care, leaving the federal government to provide for the common defense and other matters reserved for itself.
I do not object when federal staffing levels represent the bare minimum standards, which is the case in staffing ratios proposed by the Centers for Medicare & Medicaid Services. Many states — including Delaware — hold themselves to higher benchmarks.
Unfortunately, Delaware barely surpasses the federal standard. Worse, for budgetary reasons, Delaware has not even met the “staffing ratio stretch goal” that Eagle’s Law set for itself when it passed into law in 2000.
The centers’ study notes the complexity of health care quality assurance. While the report suggests that higher staffing levels are not associated with quality of care — as Rep. Danny Short, R-Seaford, mentions in his recent Opinion — it also found that higher staffing levels correlate with reduced hospitalizations, faster care and fewer lapses in care provision (“Staff mandates for nursing homes would hurt patients").
Another pivotal study by the Centers for Medicare & Medicaid Services, in 2001 (ncbi.nlm.nih.gov/pmc/articles/PMC7328494), revealed a direct correlation between increased staffing ratios and enhanced care quality. Insufficient nursing staff poses a significant threat to nursing home residents’ well-being, a fact well documented since the 1980s and reaffirmed by this study.
Continued blanket staffing ratio waivers for Eagle’s Law from the state Department of Health and Social Services for Delaware-run nursing homes are not the best solution. Conversely, merely raising them may not work — as Rep. Short points out — because creating a job does not necessarily create a qualified employee to fill that job.
Instead, Delaware should implement technological advancements that alleviate nurses’ workload and improve morale. Improved nurse call systems and updated software can streamline operations and enhance one-on-one resident interaction. In addition to higher wages and state benefits, a better “command climate” created by best-practice leadership in nursing homes can make for less turnover and happier staff engagement with residents.
All these things were suggested for implementation in the Delaware Veterans Home by a group of concerned taxpayers in December 2021 and joined by veterans’ group leaders and elected officials. Taxpayers are frustrated by funding a 144-bed facility that routinely houses less than 60 residents because mandatory staffing ratios prevent the admission of new residents.
This same group of concerned taxpayers is made of family members who saw the quality of life of their loved ones diminish because poor leadership in the Veterans Home was allowed to drive qualified staff away at the beginning, just before the pandemic. During this time, the state hired two outside contractors to “fix” the problem, and most of their solutions seem to have gone unheeded.
The good news is the current administrator of the facility seems to be a good leader. The bad news is that she has an uphill climb to overcome years of low wages never requested to be raised, low morale, too many contractors versus state employees and insufficient tenured staff.
The festering issue of the Delaware Veterans Home is now getting attention at Legislative Hall. The secretary of state’s suggestion to privatize it did not get traction at a recent Financial Committee hearing — thank God! Perhaps our legislators will go further to create a cabinet-level secretary of veterans affairs. Elevation to cabinet level, with a veteran in charge, has worked in other states and would focus more on the home, the veterans’ cemeteries and attracting more federal Veterans Affairs dollars to our state. Delaware’s 70,000 veterans and all taxpayers would benefit from such a bill.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
