Not all New Jersey nursing homes are dangerously understaffed and out of compliance with our laws, but consider this: Six out of 10 homes don’t employ the legally required number of health care aides, and our Department of Health seems reluctant to do anything about it.
The solution to this is simple, if only the state were willing to enforce it: lock down entry to these facilities and restrict their admissions until they prove they are in compliance.
Nursing home operators often say this is draconian and unfair. But the staffing law was crafted in response to a pandemic that killed more than 9,000 residents and workers inside homes that had become death traps. Since February 2021, it mandates a full team of certified nursing assistants (AIIC) and establishes a ratio of the number of residents for each caregiver.
This ratio was set at 1 to 8with one CNA for every 8 residents on the day shift, but a survey by NJ Advance Media found that some CNAs – mostly women, minimum wage workers, doing backbreaking work with a 100% turnover rate – are required to care for 15 residents each during a single shift.
Operators who jeopardize the health of the elderly and thus disrespect workers could use another guideline.
“There is no excuse for the lack of implementation of these standards, whether by industry or the state,” said attorney Richard Mollot, the executive director of Long Term Care Community Coalition. “If a nursing home cannot or does not want to hire more care staff, it must stop accepting new residents.
“This is the whole point of the law: to put an end to the commercial practice of welcoming residents without having sufficient staff to meet their needs.”
State long-term care ombudsman Laurie Brewer is more blunt: “It’s madness to admit extra residents when you can’t take care of the ones you have,” a- she declared.
The Department of Health has 76 inspectors, but needs more staff to cover 370 nursing homes, which are polled every 9 to 15 months. There have been 20 admission restrictions issued in the past 26 months, a spokeswoman said, but these were far more likely to be related to breaches of COVID protocols than staffing issues.
With 59% of nursing homes failing to comply with staffing ratios in the first quarter of 2022, the DOH is failing to force compliance.
And for workers, little has changed since the height of the pandemic. The work is dangerous, the pay is meager, CNAs often work multiple shifts to make ends meet, and whatever benefits they have earned are often taken away once the facility is sold to a private equity firm – this is where the industry is moving. lightning speed.
The situation only gets worse when their employers are allowed to thumb their noses at the staffing ratio.
Andy Aronson, who represents nursing homes as CEO of the Health Care Association of New Jersey, says the operators can’t be blamed because of the “number of CNAs needed. . . .to comply with the law does not exist.
The industry, however, doesn’t exactly earn stars for recruiting, training, or providing fair compensation, like a living wage. Instead, it perpetuates a system that treats employees like disposable parts in a job with a 100% burnout rate, in part attributable to New Jersey’s low reimbursement rate for Medicaid, which pays 70% of residents of our nursing homes.
Senator Joe Vitalethe chairman of the health committee who has already passed more than half a dozen bills to begin what he hopes will be an overhaul of the industry, is in constant discussion with the industry over the reimbursement rate .
But he adds that “there must be accountability – quality and good results must follow the money”, so he welcomes a discussion of reducing admissions for chronic understaffing.
Until then, the alarms persist. We are dealing with a marginalized population who deserve quality care, there is little accountability for the use of public funds and there is lax enforcement when homes flout the rules. The company has to change, and then the industry and the body responsible for overseeing it have to respect those changes.
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