Nursing homes are the environment that takes care of the elderly and brings peace of mind to the caregivers. This precious space is facing one critical issue of being understaffed. According to The American Healthcare Association, 84 percent of nursing homes have been reported to be understaffed. Dr. Jasmine Travers is a gerontological nurse practitioner and an assistant professor of nursing at New York University Rory Meyers College of Nursing. She has been exploring this subject and explains why this is a matter that should have everyone’s attention.
“Just think about the nursing home setting. When we have these numbers we say: This is the number to provide the safest amount of care—when we don’t have that number that means we might not have a sufficient number of nursing assistants, for example, to answer call bells. If we don’t have that number that we need to answer call bells and respond to residents’ needs, that means residents are going to sit in need of help for longer periods.” said Dr. Travers.
Nursing home staffing affects the quality of care for the residents. Lack of care in nursing homes can lead to severe consequences for the elderly community. The staff of nursing homes are the people who get the elderly out of bed, clean them, and attend to personal needs they can’t do themselves. When these tasks are not done Some nursing home residents suffer. Some fall because they try to get out of bed themselves, and some get urinary tract infections because nobody assisted them using the bathroom and they were sitting in their spoilage.
“ If a person doesn’t have someone to get them out of bed, sometimes they might try to get up and out of bed themselves. When they do that they could be at risk for falling or if they stay in bed and they’re soiled, they’re at increased risk for UTIs or increased risk for pressure ulcers. So these are the types of things that we see as a consequence of decreased staffing, which is an important issue that we need to address.” said Dr. Travers
Dr. Travers shares that there are 15,000 nursing homes across the country and approximately 1.2 million individuals living in them. To provide an adequate amount of care, the total nursing hours should be about 4.1 hours per resident per day. This includes the registered nurse, the licensed practical nurse, and the certified nursing assistants according to a study from the Centers for Medicare & Medicaid Services. Unfortunately, only 25 percent of total nursing homes are reaching this benchmark.
The Covid 19 pandemic played a role in the staff shortage. Dr.Travers elaborates that the pandemic affected occupancy in all nursing homes. Fewer residents in nursing homes meant a decrease in revenue for facilities. The decreased revenue means facilities can not afford the staff on hand and that limits the care that can be provided to the nursing home residents. A group that was hit the hardest with this problem is nursing homes located in underserved communities. Dr. Travers goes into detail about how the socioeconomic level of a nursing home affects the desirability for residents to live in and professionals to work in.
“If there’s lack of transportation in a more severely deprived setting, then a person most likely isn’t going to work in a nursing home in that setting or live in that If housing is poor, if education is poor it may not be a desirable place to work. If a nursing home is located in these types of areas, we just might see fewer resources that are provided to those nursing homes to be able to create better working environments and provide better opportunities for better care for residents—which further just decreases someone’s desirability to want to work in that nursing homes” said Dr. Travers
Two solutions Dr. Travers does see for the staff shortage issue are supporting the current staff of professionals working in nursing homes and making the career field more desirable for people to join. Incentives are one way to support those professionals. The Centers for Medicare & Medicaid Services recently announced reimbursements and loan forgiveness for professionals who work in nursing homes in underserved areas. Dr. Travers encourages higher pay to keep current nursing home professionals and bring in new individuals. She also believes organizations should put effort into retention.
“We’re focused on meeting minimum staffing levels, but we’re not as focused on decreasing turnover. Turnover is associated with the work environment at these nursing homes. We need to change the work environment so people will stay. When people stay longer, they know their residents more. That consistency translates to better quality of care for the nursing home residents,” said Dr. Travers.