Ky. voices: Time right for nursing-home staffing standards

There should be staffing standards for nursing homes in Kentucky, and the public knows it.

A recent survey by state Sen. Denise Harper Angel in her Jefferson County 35th Legislative District showed that 83 percent of 2,000 constituents she polled favored "minimum staff-to-patient ratios for nursing homes and other long-term care facilities."

Advocates for nursing home reform remain confident that if all the people in Kentucky were asked about their feeling on staffing standards, the answer would come out the same way.

There is a preponderance of evidence that staffing standards work to improve the quality of care. Just ask the people in Florida, California and Arkansas — where staffing standards are in place and helping improve the quality of care.

Staffing standards for caregivers in Kentucky are nothing new. There are now staffing standards for day-care centers for both children and adults. Why not nursing homes?

The answer is that the nursing home industry is big, wealthy and powerful. It is very good at persuading lawmakers that staffing standards are not needed and at plying lawmakers with money for reelection campaigns.

The industry has many excuses for why it is against staffing standards. One of them, of course, is money.

But when the 2004 Kentucky General Assembly increased the provider tax for nursing homes, matched by the state and returned in tripled reimbursements to nursing homes — a $60 million a year windfall — the promise was to use this money to improve the quality of care. We have not seen evidence that even a penny of that was used to improve caregiving, and certainly not to improve staffing.

Then there's the human aspect of this problem. Advocates for nursing home reform are careful not to demean the hundreds of nursing home workers who provide tender, loving, quality service to their patients.

Indeed, advocates admire these people, especially the nurses' aides who work long hours above and beyond the call of duty to do what is right and watch over their patients. And this goes for some nursing home administrators, too. We have had some of them tell us they know there are not enough front-line caregivers in their facilities. But greedy corporate bosses won't let them spend money to hire more people.

Even with all the excuses and intense lobbying by the nursing home industry, could this be the year that the legislature does something to help the forgotten Kentuckians?

Could be. We say that because this session is coming on top of hard-hitting news articles on elder abuse and neglect in the state's two largest newspapers.

In response to these reports, Gov. Steve Beshear has directed his people to look into the problems uncovered. A refurbished and re-energized committee on elder abuse is meeting. And one legislator, Rep. Tom Burch of Louisville, has introduced a bill that would call for coroners to help identify cases of abuse and neglect in nursing home deaths.

Rep. Carl Rollins of Midway is coming back again this session with a staffing standards bill. And he will most likely be joined by Sen. Ray S. Jones of Pikeville, who will be introducing a similar bill in the Senate.

Staffing standards are probably the single most important action the lawmakers can take to ensure nursing home residents are well cared for. Certainly, there are other factors, such as the quality of facility managers and the training caregivers receive. But minimum staffing standards must be done before these other improvements are effective.

For example, one cannot expect a well-trained caregiver to do a good job if he is trying to care for 15 or more people alone.

Could it be that the word is finally getting out to our state legislators about how their constituents support staffing standards?

Or are our lawmakers getting older and afraid that they, too, might end up in nursing homes?