Esham: Coalition disagrees about nursing home staffing mandates

Posted

The Delaware Elder Care Advocacy Coalition was formed by families who promote legislation for Delaware’s aging residents to ensure they receive quality care and thrive. We are writing in response to recent Opinion pieces in the Daily State News by Rep. Danny Short, R-Seaford, and Rep. Jeff Hilovsky, R-Millsboro (“Staff mandates for nursing homes would hurt patients” and “Actions need to be taken to avoid staffing mandates"). We are grateful for Rep. Short’s support on the four recent long-term care reform bills and Rep. Hilovsky’s support on one of the four.

While we agree the workforce in the long-term care industry is challenged, we disagree that staffing ratio requirements “hurt patients.” In these pieces, it was stated, “(N)ursing homes turn away new residents because they don’t have enough staff.” According to the Non-Acute Long-Stay Patient Task Force meeting Feb. 27, 300 residents who are currently in acute settings aren’t able to be discharged due to placement issues and not due to staffing issues in skilled nursing facilities. We encourage legislators to listen to the task force meeting and be involved with the members in the solution to moving these residents out of a hospital setting. Also, the Department of Health and Social Services secretary was asked by Sen. Laura Sturgeon, D-Woodbrook, in the Joint Finance Committee hearing around 12:15 p.m. Feb. 20 if there are residents waiting for beds in skilled nursing facilities. The secretary responded, “It is typically not because there is not a bed available and typically a compounding factor. Those folks are stuck for other reasons.” The reason residents remain in the hospital longer than needed for the level of care is not due to a lack of beds in skilled nursing facilities. It is important to properly analyze the problem and causal factors before determining solutions or simply condemning legislation without providing a solution.

On Feb. 26, Sen. Spiros Mantzavinos, D-Elsmere, and Rep. Kendra Johnson, D-Bear, released a four-bill package for long-term care reform. Senate Bill 217 is one of the bills, and it focuses on creating financial assistance in the form of a professional loan-to-grant incentive program to encourage Delawareans to pursue careers in nursing at long-term care facilities. Enabling a workforce to invest in a career taking care of our most vulnerable population is critical. We encourage support on this bill.

There are several studies, including the “Appropriate Nurse Staffing Levels for U.S. Nursing Homes” report, that show a “strong positive relationship between the number of nursing home staff who provide direct care to residents on a daily basis and the quality of care and quality of life of residents.” Another study conducted by the Institute on Aging noted the following relationship between quality-of-care requirements and nurse staffing requirements:

  • Insufficient nurse staffing levels, nursing staff without needed qualifications and high nursing staff turnover rates contribute to inadequate care of residents.
  • Staffing shortages, staff burnout and lack of needed staff training contribute to mistreatment of residents.

Lack of oversight and standards in long-term care facilities can cause grave danger to our most vulnerable populations. There have been several cases in our state in the last few years:

  • In February 2021, a resident of Dover Place died due to sepsis and MRSA from a wound beyond the level of approved care in an assisted living facility. The state investigation determined that for two of the three sampled residents, the facility failed to revise the service agreements when the needs of the residents changed.
  • In May 2021, a resident of Courtland Manor in Dover died from sepsis and organ failure. The lawsuit claims the nursing home staff failed to change the resident’s catheter for more than a year.
  • In February 2022, a resident of Newark Manor was found dead outside, after she fell off the balcony. The facility was sued by the attorney general’s office for long-standing issues from 2011-17, including being understaffed.

These are only a few of the devastating stories of lack of care occurring in our state. We should not be condoning opening beds in facilities simply to have a physical place for residents to stay without requiring these facilities to ensure quality care is provided, especially when lack of beds isn’t typically the cause for long-term hospital stays.

In addition, skilled nursing facilities are not the only option for discharge from the hospital. Home health care agencies are options to provide care in the comfort of patients’ own homes. However, there is a two-year backlog on business owners waiting for the application process with the Delaware Division of Health Care Quality, as discussed in the Joint Finance Committee hearing. Last year, there were 94 interested providers for new home health care agencies.

The state has established a Caucus on Aging, led by Sen. Mantzavinos and Rep. Johnson. The next meeting will be Thursday from 10:30 a.m. to noon in Room 112 of the Tatnall Building in Dover. Director Andrew Wilson of the Division of Medicaid and Medical Assistance will be the guest speaker. For information, contact Brandon Williams at brandonf.williams@delaware.gov. We encourage legislators to join the conversation to understand the problems and work to provide solutions in our state, ensuring our aging residents thrive.

Candace Esham

Founder, Delaware Elder Care Advocacy Coalition

Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.

Members and subscribers make this story possible.
You can help support non-partisan, community journalism.

x
X