It can be emotionally trying when your loved one’s needs are so great that they must reside in a nursing home. You should have a measure of comfort in knowing he/she will get great care. But that comfort can be elusive, in large part because of an industry-wide problem: chronic understaffing.
In 2023, the Biden Administration’s introduced an initiative to increase staffing at nursing homes. That proposal was challenged in court and has now gone down in defeat.
Staff Shortages
Nearly all facilities struggle to recruit staff. The Long Term Care Community Coalition reports that in the third quarter of 2024, 90% of facilities nationwide lacked adequate staff; and a 2024 poll by the American Health Care Association reveals that 94% of facilities have difficulty recruiting personnel.
There are a variety of reasons for this situation. First, the covid pandemic sparked an exodus of staff from which the industry has yet to recover. Second, an increasing number of homes are being purchased by private equity firms, creating an increased incentive to cut costs. Third, the crackdown on immigration is squeezing nursing homes: According to KFF Health News, more than 800,000 immigrants and naturalized citizens constitute 28% of the direct care staff at nursing homes, assisted living facilities, home care agencies and other long-term care companies.
In 2023 the Biden Administration introduced federal minimum staffing rules for facilities that receive federal funding, including upgraded standards for numbers of registered nurses and nursing assistants. However, the initiative was embroiled in controversy from the start. Industry groups opposed the measure, saying it was too costly and there simply were not enough people willing to take the jobs. After months of legal wrangling, the Department of Health and Human Services has ceased appealing. The federal staffing mandate is not to be.
Florida has its own standards for nursing home staffing. For example, a facility must have one certified nursing assistant for every 20 residents, and no less than one licensed nurse for every 40 residents. Florida nursing homes are finding it hard to meet those standards, too. You can read the detailed rules here.
Do Your Research To Find A Nursing Home For Your Loved One
There is no substitute for doing your own research. There are a variety of resources to help you figure out the best nursing home fit for your loved one, and what the staffing situation is at the home:
- Use the Medicare compare tool. These ratings go from one to five stars. A variety of factors are considered in the rating. One important factor to check is the turnover rate. It is high in general – the national average is 52%. Anything even higher than that could be a red flag.
- Check out statistics at the Florida Agency for Health Care Administration
- See Pro Publica’s list of nursing home inspection reports here.
- Solicit recommendations from doctors, your elder law attorney, other professionals, friends and neighbors.
- Get in touch with the long-term care ombudsman program. Find contacts for Florida and nationwide here.
- Search out news coverage and google reviews of facilities. But keep in mind that even the most stellar facility will likely garner some bad reviews; that is just the nature of the social media beast.
- Visit the facility during regular hours – and during off hours (evening, weekends). Observe:
Safety and cleanliness.
How are the residents treated? Do staff seem to know their names?
Stick around for mealtime. Try the food. See if residents who need help eating get the help they need.
If possible, talk to residents and get their impressions.
Is there a family council? Get in touch with it and see what their experiences have been. If possible, talk to relatives of residents.
Find out what percentage of nurses and nurses aides are on staff versus hired as temp workers. The higher the proportion of regular staff, the better.
Find out how long administrators have been on the job. Stability tends to be a positive.
Talk to staff. Do they seem comfortable in their jobs?
AARP has a checklist you can print out, refer to and take with you when you visit. Click here.
Our Attorneys Can Help
Going into a nursing home can be the best choice for someone who needs help with activities of daily living and cannot receive care at home. However, family members are well-advised to find the best fit for their loved one. Also, keep in mind that there may be alternatives to nursing home care – day care, V.A. Aid & Attendance assistance, and Medicaid waiver programs that can help pay for at-home help.
The attorneys of The Karp Law Firm can help you understand Medicaid benefits and other benefits that may be available for your loved one, and help preserve assets before you spend down and lose your nest egg to nursing home costs.We have been helping families find solutions to these problems for over 30 years. Reach out to us at 561-625-1100.
