Archive for Saturday, September 9, 2000

Staffing is key

September 9, 2000


To the editor:

Regarding your report on nursing home staffing, it is the same old story, the regulators say it is not really so bad, and the industry blames poor reimbursement and an "unfair" image. Minimum staffing in Kansas still provides no real safety net at all. The federal report underscores what my mentor, the late Petey Cerf of Lawrence, said for years: the real problem in nursing homes is understaffing.

The recent federal HCFA study found that more than half of all nursing home residents are at serious risk of harm due to inadequate staffing. Understaffing is not an abstraction. It results in malnutrition, dehydration, broken bones, bedsores and depression among other maladies.

The average rate of turnover of aides is 80 percent to 100 percent each year. There are many reasons aides do not stay, including understaffing, poor management, low status and low salaries. Pat Maben, a good regulator, suggests that a home staffed for 100 percent occupancy when only 80 percent full is really 20 percent ahead. If KDHE can show me ANY nursing home in Kansas that has 20 percent more staff than all of its residents need, I will eat my hat. KDHE often fails to cite homes for understaffing unless actual harm has already occurred. This study suggests that KDHE is in error.

I don't begrudge an honest facility adequate reimbursement to provide necessary services. But, before we throw more money at nursing homes, we must tie additional dollars directly to staffing and then do field audits to follow the money.

The nursing home industry is now promoting "single task worker" legislation in Congress. The industry wants a new type of aide with even less training than the bare 90 hours Kansas aides receive now, so they can be hired just to "feed" or "bathe" residents. This is dangerous because it segments care, weakens training and will compound the problem of understaffing.

On any given day, Kansans should be able to go to a nursing home, see posted staff and resident counts and know that a minimum is being met.

The public must decide now, will we hold nursing homes and regulators accountable, will we stop the unnecessary suffering of residents and are we willing to pay a reasonable price for it?

Margaret Farley,


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