CALIFORNIA FOCUS
FOR RELEASE: TUESDAY, NOVEMBER 2, 2021, OR THEREAFTER
BY THOMAS D. ELIAS
“NURSING HOMES FACE A NEW
LIFE-OR-DEATH CRISIS”
The COVID-19 crisis is over at California’s hundreds of nursing
homes. Or is it?
Like nursing homes around the nation, this state’s skilled
nursing facilities and the somewhat similar assisted living homes were the
state’s most tragic dying grounds during the height of the pandemic.
They accounted for almost 48 percent of Covid deaths here and
elsewhere, yet their residents make up just a small fraction of the overall
populace. The advanced age of most nursing home residents put them at more risk
from the virus than younger people and tens of thousands of them died at
alarming rates.
But that’s largely over. The advent of vaccines from
companies including Pfizer, Moderna and Johnson & Johnson and the
government’s prioritizing immunizations for the elderly has cut the
Covid-related death rate among nursing home denizens by 96 percent.
That did not relieve the other, ongoing crises still taking
their toll in nursing homes and related facilities.
Visitation is still limited there (and in virtually all hospitals)
to one guest per day in most locations. For many nursing home residents, this
means seeing their grandchildren or their remaining friends either through
ground-floor windows or electronic services like Skype or Facetime – a recipe
for extreme loneliness and disorientation that has prevailed since Day 1 of the
Covid lockdowns.
Plainly, the lack of visitation (almost absolutely banned
through the worst of the pandemic) did not keep death out of the homes. While
guests did not affect the residents, infected and contagious staff members did.
So it became urgent to hire solid staff willing to get vaccinated
and maintain lifestyles featuring masking and social distancing. But the pay
for these staffers – many of them compelled to work multiple jobs – did not
rise appreciably.
A worker shortage results. Like many other businesses,
nursing homes now find themselves short of help.
A national survey of more than 700 members of the American
Health Care Assn. (AHCA) and the National Center for Assisted Living, trade
groups for the homes, found that 94 percent of nursing homes have had a
staffing shortage during the last month, with 81 percent of assisted living
communities reporting the same.
Jobs are going begging. But for the most part, these are not
extremely high-paying posts. That’s in part because the homes try to maintain
healthy profit margins and in part because most homes cater to Medi-Cal or
Medicaid patients, for whom payments lag far behind what most home-care
companies or luxury retirement homes charge.
The AHCA says payments from those government-run programs cover
just 70 percent to 80 percent of the actual cost of care.
As a
result, most homes are short-staffed. For residents who are not ambulatory,
this can mean multiple consecutive entire days spent in bed, often with no
visitors and minimal outside human contact. That’s because staffers frequently are
too overworked to do the hard physical labor of helping people out of their
beds and into wheelchairs or getting them to seating in lobbies.
Says
the AHCA, “Without a fully-funded Medicaid program (Medi-Cal is the California
version of Medicaid), providers will continue to struggle to become competitive
employers.”
That’s
especially true in a dog-eat-dog labor market with hundreds of thousands of
easier jobs available, from store clerks to Uber drivers.
As solutions,
the AHCA recommends loan forgiveness
for new college graduates who
work in long term care, tax credits for licensed nursing personnel in the
homes, childcare assistance and affordable housing for nursing home workers.
That’s
a menu not among the highest priorities today in either Sacramento or Washington,
DC.
But
lawmakers should make these kinds of incentives just as high a priority as they
made getting nursing home residents vaccinated last winter, when large cadres
of health care workers were sent into the homes to administer shots.
If
at least some of these tactics are not deployed, and
soon, untold tens of
thousands of nursing home residents will be doomed to unnecessarily dreary,
lonely lives in a long-lasting but little publicized side-effect of the
pandemic.
-30-
Elias is author of the current book
“The Burzynski Breakthrough: The Most Promising Cancer Treatment and the
Government's Campaign to Squelch It,” now available in an updated third edition.
His email address is tdelias@aol.com
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