We don’t normally get into the political side of things on these blogs, but this particular topic impacts our practice and more importantly, our clients and families. President Biden and his administration have recently announced some new proposed rules regarding nursing homes. We’re excited about some of these nursing home reforms, but are also disappointed that they are omitting one key element of elder care.
Priorities of The Nursing Home Reforms
There are three main priorities of these nursing home reforms:
#1 Minimum Staffing Requirements
During the pandemic, many jobs were lost for a variety of reasons. Some jobs were lost as people were fired due to budget cuts. Others simply quit their jobs. Regardless of the reason, the nursing homes have still not recovered and are very understaffed.
#2 New Payment Changes
Nursing homes will now receive funding based on a wide array of criteria. This would include the adequacy of the staffing and the overall experience of the residents. Think of this as kind of a “Trip Advisor” ratings system for nursing homes.
#3 Ability of a Facility to Maintain a Staff
Staff maintenance at nursing homes is a complicated issue. But most of the responsibility for quality staff falls on the management of the nursing home. The government wants to regulate the nursing homes more and provide more public information regarding the quality of each nursing home.
A Missing Piece of the Nursing Home Reforms
While these new nursing home reforms are mostly good, they fail to address a resident’s right to have emotional support and socialization from their family. Family caregiving is a very important part of elder care. Socialization is important to those who are staying in a nursing home. During COVID, there were thousands of seniors in nursing homes who died lonely and depressed due the lockdowns.
During the lockdown, the death rate of seniors was 20% higher. This is primarily due to lack of socialization and the mental toll that it can take on an elderly individual. Although these nursing home reforms can surely be helpful to seniors, I don’t think they do enough to ensure that families can still visit their loved ones.
One of the main arguments against visitation is that the families are bringing in COVID-infected individuals and spreading it amongst the patients in the nursing home. But this isn’t necessarily true. Most of the COVID outbreaks in nursing homes actually came from the staff. The staff goes home at night and interacts with their friends and family, then brings the virus back to work with them the next day.
There has to be some kind of happy medium where residents can still be allowed to socialize and interact, while being kept safe from outside sources of infection. A resident’s right to emotional and social support should be upheld so that they can have a longer and higher quality life. The bureaucrats are always pushing more rules and regulation, but we have to use common sense in some instances to protect our seniors.
More Specifics of the Nursing Home Reforms
Other items in these new nursing home reforms include reducing the room crowding. Everyone wants to have a private room, but it’s not always feasible for everyone. A private room can cost roughly $8,500 to $10,000 a month while a semi-private room averages about $6,500 a month. So not everyone is going to be able to afford that privacy of having their own room. In an attempt to solve this issue, the nursing homes are going to try and make the rooms smaller so that more patients can have a private room.
They’re also going to try and reduce the overmedication that is problematic in many nursing homes. Personally, I don’t think the staff are trained well enough in most cases. I think they should be required to have more education for the job that they are required to do. If a non-responsive senior is crying or moaning, the tendency is to just give them something that will make them sleep. I’m not a doctor, but that doesn’t seem like that should always be the response.
They’re going to enhance the accountability and oversight of the nursing home, which basically entails more inspections. To use Georgia as an example, the inspections are lagging 2-3 years due to understaffing and budget cuts within the State. With these new nursing home reforms, the Federal government is promising more money to inspection agencies to get these nursing homes inspected and ensure they’re providing a quality standard of living.
They’re going to increase the scrutiny on underperforming nursing homes. The Center for Medicare and Medicaid Services (CMS) has a term called “Special Focus Facility.” These are facilities that have been inspected, have scored very low in certain areas, and are at risk of losing their license. If you go to the CMS website, you can actually find a list of these Special Focus Facilities that are being closely monitored.
They’re going to create pathways for better paying nursing home jobs and encourage the nursing home workers to unionize. Without getting into the political weeds of unions, I do often worry how nursing homes are able to keep good help given the current situation in our country. What makes someone want to work for $12 in a nursing home when they can make that much on government benefits alone? We have to figure a way to incentivize talented individuals to come work at these nursing homes and we have to pay them properly.
They’re going to do more as far as COVID 19 responses to help patients stay vaccinated and boosted. They’re going to integrate all the things they learned during the pandemic so that they’ll be better prepared for the future. Unfortunately, they haven’t overruled the total lockdown, which is a big problem in my opinion. The total lockdown eliminates all socialization and really has terrible mental impact on our seniors in nursing homes.
Of course the government response to my lockdown opinion would likely be that they’re going to use technology to improve socialization during lockdowns. But that doesn’t always go as planned. Nursing home patients aren’t familiar or comfortable with FaceTime or Zoom call technology, and are not likely to use it to keep in touch with family members. Staff are also not likely to encourage digital meetings because that’s more work for them to setup those calls.
Contact Us So We Can Help!
I hope this information on nursing home reforms has been helpful to you, especially if you have loved ones who are in a nursing home or will soon be needing nursing home care. I hope it has spurred some important questions that you will ask the nursing home. We have a heart for our seniors and want them to receive the best care possible in their last years with us.
If you have any additional questions regarding nursing home care for a family member, please complete this form or give us a call at (229) 226-8183. You can also send us an email to [email protected] We’re here for our seniors and their family caregivers.
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