Staffing Ratios and Reality
Posted by Kim on April 21st, 2008 / 
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The costs of mandated ratios is too high, even for Democrat state lawmakers. The politics of long term care don’t matter. Money does.
We should remember it all comes down to taxes WE pay. The federal government pays the states a certain sum of money for each certified bed; the states then have to pay the difference in actual costs. Either way it all comes out of the same pool: Our income. States have choices to make: Fund nursing home CNA ratios or health care clinics or womens’ crisis centers, and any of the MANY programs we all see in our localities.
State Democratic lawmakers probably will scale back their plan to boost the state’s minimum-staffing levels at nursing homes after receiving a new financial report Friday that shows their proposal would cost four times the amount originally estimated.
The new projections by the state Office of Fiscal Analysis estimate that raising the staffing minimum to 4.2 hours of daily nursing care per resident would cost the state $44.5 million next year under a proposed phase-in plan that would gradually raise the minimum. In subsequent years, the higher minimum could cost $115 million annually.
Democratic lawmakers who proposed the reform had allocated $10 million for the phase-in next year, but that allocation was based on initial estimates that were not calculated on the actual hours of nursing care provided.
State Sen. Edith Prague, D-Columbia, said Friday that the proposed staffing minimum may have to be revised to 3.6 hours of care a day because of funding constraints.
The facts are not pretty. In the US there are 1.8 million people residing in nursing homes. That’s roughly 6% of the population of people over 65, which is less than 1% of the total US population.
People are not going to pay more taxes to fund the health care of such a very small percentage of our population. Even with the arrival of the baby boomers, I don’t see this changing TOO much. The boomers are far better prepared for their retirements and have saved much more money. Some of them will end up in Medicaid funding nursing homes but most will be able to stay in their homes or reside in assisted living or group home type facilities (which are private pay).
I know a lot of people are banking on the boomers as being the saviors of staffing ratios, but it isn’t going to happen. If anything staffing will get worse because the boomers are parents to many less (working and tax paying) adult children. The vast pool of money has shrunk substantially and this is why we might be facing a crisis with social security, along with all matters related to public subsidizing of health care programs. Medicaid will be in trouble soon too. There will not be enough money to fund the programs.
Tough things to think about.
April 21st, 2008 at 6:24 pm
Very sad, but very true statements. Either way, as the nursing home crisis continues, soon the private group homes will have their problems with staffing. Until we value our caregivers, the problem will not be fixed. We need to value our senior’s quality of life. And then we wonder why there is a whole new attorney industry in sueing nursing homes. Until it is cheaper to hire more staff than to pay out lawsuits nothing will change.
April 22nd, 2008 at 7:05 am
The inability of our nation to see the outright needs of the human population before it, present in long-term care facilities, assisted living, and through in-home care, is astonishing. Denial is no cure; the care must extend from the persons being taken care of all the way through those providing the care.
No person being taken care of should ever find themselves wondering when an aide, nurse, or other medical personnel is going to arrive. When that aide or nurse does come through their door, that person should never doubt that they will have time for more than quick medical exchange and a rapid smile before that aide or nurse dashes back out their door. Human interaction IS part of medical care.
No nurse or aide should ever have to struggle financially, or wait months for insurance to start back up after changing employers; ever! No matter where a medical professional works; in long-term care, assisted living, in-home care, a hospital, a clinic – they should have an adequate income and insurance coverage from the day they start working.
The industry itself needs to question its own motives. What is most important? People? Or Money? The Healthcare Industry is in existence for one purpose – the care of human lives, i.e. people. Every single person at the top of the corporate ladder needs to take a major pay cut if necessary in order to hire enough aides and nurses to staff by acuity. The American population needs to recognize that they, too, can get in a car accident, fall on the street, or get hit by a car, have a stroke or heart attack, and end up in a Nursing Facility as well – And Pay Those Taxes that will get facilities to Staff by Acuity.
Whatever it takes, folks – these facilities *have* to be staffed appropriately. Doing anything less; denying healthcare workers decent wages and insurance, denying human care for human beings – results in a middle-ages and cruel scenario of something that no longer resembles decent health care. Doing anything less than treating people like human beings is denying the very concept of what Health Care is.
April 22nd, 2008 at 4:17 pm
Chuck I think there is more here. Kim is saying there are not enough old people in nursing homes to catch the attention of the American public. I had no idea there were so few..I always thought there were millions and millions. Not just a million or so. I verified this at the CMS website.
So the point is there are less than 2 million people living in nursing homes and yet it is costing the country billions to care for them.
This means that down the road when the boomers enter the nursing homes, we will see an increase in funding need but less people working and paying for the care. Even if we are each taxed to the max it might not be enough. The tax burden might become to high and then what? I don’t like this at all. But I can’t argue with facts. We can demand the government pay more. But the fact is WE will have to pay more. I am willing to do that up to a certain point…after all, you, me, all of us, have our own lives to lve and bills to pay and food to eat. I make so little money now I cannot see paying more.
The rich people can and should pay more in taxes. I don’t think that will cover it either though. And we can be sure the government will protact the wealthy from ever paying their fair share. Although I am not sure its really fair.
April 22nd, 2008 at 4:23 pm
Thomas you speak in generalizations. I agree with most of what you think though. Health care is CARE. But someone has to pay for it. Otherwise the nurses and aides won’t get PAID right? So there has to be a business end to it all. Thomas you’re not aware that in most places of employment new employees have to wait 30 to 90 days for insurance? Not just health care. Most places have those rules in place because of the turnover rate in the first three months. My DH works for a factory and he waited three months, and that was 12 years ago.
I do not think nursing homes should ever be able to be sold for stock or investments. That’s wrong. Nursing homes should be exempt from that stuff. No one should be able to make money on residents.
Same with hospitals.