Staff Shortages and other Problems Persist in U.S. Nursing Homes

Federal investigators have found that infection control lapses, severe staffing shortages, employee burnout, and lowering vaccination rates are persistent problems in the nation’s nursing homes, with much of the circumstances being leftovers from the COVID pandemic that are proving resistant to fixing. As reported by the New York Times (NYT), which reviewed the report, many facilities are struggling to stay afloat. Some have had to reduce their bed count; some have closed. “For nursing homes, the inability to attract and retain certified nurse aides, dietary services staff and housekeeping workers is tied to federal and state reimbursements that do not cover the full cost of care,” the NYT stated. Nursing home administrators say they’re caught between needing to hire more staff at higher wages and too little revenue to afford it. The findings in the report were turned over to the Centers for Medicare & Medicaid Services (CMS), the agency that oversees 1.2 million nursing home residents whose care is provided mainly by the federal government. CMS reportedly declined to discuss the report’s recommendations but did say a new federal program will provide $75 million in scholarships and tuition reimbursement for those pursuing careers in nursing.

The lowered vaccination rates for both residents and staff in nursing homes is concerning because at the height of the COVID pandemic in 2020, two in five Medicare beneficiaries in nursing homes were infected with COVID. More than 1,300 nursing homes had infection rates of 75 percent or higher during surge periods, with accompanying surges in death rates. Now the spread of vaccine misinformation has exacerbated the problem. The CDC says only 41 percent of nursing home residents and 7 percent of employees are up to date with vaccines. The federal report highlighted creative solutions that some nursing homes successfully used to retain staff. These have included hiring bonuses, free staff meals, and a decision to take advantage of licensing waivers that allow providing nursing assistant students with on-the-job training. Other suggestions offered are to include nursing aides in the temporary worker visa programs and make Pell grants available to nursing assistant students and culinary worker trainees. But more is needed to relieve widespread challenges. One public health expert in long-term care was quoted as saying the bottom-line problem is “a lack of political will to spend what it takes to support Americans in their golden years.”

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