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CRISIS IN NURSING HOME CARE

The Problem:

• Many nursing homes are understaffed, have a high staff turnover rate, and do not provide training for employees.
  
  
• Understaffing and poor training contribute to accidental deaths, abuse, dehydration,
  malnutrition, pressure sores and incontinence residents plus job injury and job dissatisfaction for employees.
  
  
• High caregiver turnover rates disrupt continuity of care. Caregivers are unfamiliar with resident's complicated needs.
  
  
• Caregivers are poorly paid, are not encouraged to provide input into care planning and are not shown respect and/or appreciation of their work by employers.
  
  
• It costs eight (8) times a caregiverís monthly salary to replace a caregiver.
  
  
• Nursing costs continue to rise although care remains substandard.
  
  
• Taxpayers, residents and families should not have to pay for substandard care, abuse and/or unsafe environments.
  
  
• Residents and families should be allowed to put cost of care in an escrow account until quality of care meets acceptable standard.
  
  
• Nursing home owners need to reinvest more of their income into care of residents, improved staff wages and maintenance of facility.
  
  
• Residents should be able to receive adequate compensation for neglect and accidents.
  
  
• Inadequacies in the enforcement of the monitoring system allow nursing home operators to continue to provide substandard care.
  
  
• Closure of substandard nursing homes is not a solution. It presents more problems: grief and depression for residents, fear of not finding another nursing home, apprehension regarding moving and meeting new people and often permanent loss of orientation for residents with dementia.
  

Scope and Severity of Nursing Home Problem:

• Michigan rates higher in the number of complaints when compared to states with similar or fewer number of facilities (Wisconsin, Minnesota and Georgia).
  
  
• Michigan spends less money per licensing agency complaint visit and federal certification than does Wisconsin, Minnesota and Georgia.
  
  
• There are over 50,000 nursing home residents in the state of Michigan.
  
  
• There are approximately 441 nursing home facilities in state of Michigan.
  

Recommendations:

• Strengthen the survey and certification system and provide prompt handling of complaints through the enforcement system. Problems need to be rectified immediately: not 6 to 12 months after incident.
  
  
• Explore alternatives to closure of nursing homes in order to develop a comprehensive plan for providing quality care for nursing home residents.
  
  
• Support House Bill 4159, which allows nursing home residents to escrow payments if their nursing home is not meeting public standards.
  
  
• Support Senate Bill 263 and House Bill 2362, which require staffing standards to be increased from 2.25 to 3.00 hours of direct nursing care per resident. Groups such as the National CitizensíCoalition for Nursing Home Reform (NCCNHR), the Michigan Campaign for Quality Care, and Citizens for Better Care advocate an increase to 4.1 hours of direct nursing care per resident.
  
  
• Support the immediate passage of House Bill 4727, which requires criminal background checks of nursing home employees.
  
  
• Introduce legislation for residents to be compensated adequately for neglect and accidents.
  
  
• Inaction is not an option. Residents continue to be neglected, abused and exposed to unsafe environments due to insufficient and poorly trained staff.
  

Approved by the Board of Directors of Citizens for Better Care on May 13, 2000.


CBC Action Sheet #2
May 13, 2000