Long before the COVID pandemic exposed deep-seated problems such as inadequate staffing and subpar resident care, many nursing homes across the country scored poorly in government inspections and faced public outrage for instances of extreme negligence and abuse.
With the pandemic in our collective rearview mirror, those problems still persist.
In Indiana, 104 of 511 nursing homes have recent serious deficiencies and 395 have recent infection-related deficiencies, according to August 2024 data compiled by ProPublica.
A similar pattern of problems across the country motivated the U.S. Health and Human Services agency to create new nationwide staffing standards for nursing homes to help assure that residents are receiving adequate care.
Indiana Capital Chronicle reported this month that current staffing levels at most of the nation’s nursing homes would fail to meet the new rules, finalized in April. Requirements include the following:
• The presence of a registered nurse onsite 24/7, up from the current requirement of eight consecutive hours each day
• At least 0.55 hours of registered nurse care for each resident per day
• At least 2.45 hours of care daily from a nursing aide The powerful nursing home industry lobby, of course, opposes the new rules. And attorneys general from 20 states, including Indiana’s Todd Rokita, have joined with the lobbyists by filing a lawsuit to fight the new federal mandate.
The lawsuit targets leaders within Health and Human Services and the Centers for Medicare and Medicaid Services, the Capital Chronicle reported.
“Instead of addressing the legitimate challenges nursing homes face, the Defendants put forward a heavy-handed mandate … This Final Rule poses an existential threat to the nursing home industry as many nursing homes that are struggling will have no choice but to go out of business,” the lawsuit reads in part.
Such projected closures would, no doubt, create hardships for some residents and their families. But many of the facilities jeopardized in Indiana by the new standards are likely the same ones cited for serious deficiencies in the August data. The closure of consistently troubled facilities could be viewed as a service to families and residents.
It’s also germane to note that the vast majority of the nation’s nursing homes that currently fail to meet the new staffing mandates are for-profit ventures.
A Kaiser Family Foundation analysis in May showed that just 11% of for-profit nursing homes meet all three of the new staffing minimums. Meanwhile, 41% of non-profit nursing facilities and 39% of governmentrun nursing homes meet the new standards.
For-profit facilities not only have the lowest nurse staffing levels per resident, they also comprise 73% of all nursing homes in the country, meaning the majority of resident care problems are intertwined with the profit motive.
The government, including the courts, should always side with the interests of people over the interests of profit. Nowhere is that more true than in facilities entrusted with the care of our aging loved ones.
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