Citizens suffer consequences of poor nursing-home staffing

At issue | April 22 Herald-Leader editorial, "Dental neglect at nursing home; poor staffing a problem across state"

The Herald-Leader was, once again, right on target. The main point of the editorial, besides that oral care in most nursing homes in Kentucky is atrocious, was that this kind of abuse and neglect is still another example of how the nursing home industry refuses to hire enough caregivers to take care of their residents.

Why is this? What's going on here where the most vulnerable of our population, our poor elderly citizens, are being mistreated day in and day out?

The answer is one word: greed.

Many of these nursing homes are owned by big corporations, many run by fat cats on Wall Street or far away from the nursing facility, where the only important report to hit their desks is the profit-and-loss statement.

Advocates for nursing home reform have been telling government leaders this for years. In Kentucky, however, no one seems to listen, or lawmakers who could help are persuaded by generous donations to their re-election campaigns not to act.

It's also a shame that the sometimes total disrespect of the elderly in these facilities by the bosses and big corporate owners reflects on the many nursing home workers who go all out to try to help.

Long hours and hard work are big problems for anyone brave enough to sign on to be a nursing home caregiver.

So something's got to be done. But how?

We know we need minimum staffing standards for nursing homes in Kentucky. They would help eliminate the abuse and neglect. They would, for example, ensure that there would be sufficient front-line staff to provide oral health care to all the residents of a facility.

What would these state staffing standards look like? They would force the nursing homes to hire the number of people necessary to provide for a ratio of one direct caregiver to every five residents on the day shift, one to 10 in the evening, and one to 15 at night.

Much research has gone into such ratios on whether they will work, and the conclusions are that they provide better nursing-home care.

In just the past year, moved by hard-hitting articles in the Herald-Leader and The Courier-Journal in Louisville on nursing home elder abuse and neglect, and challenged by Kentuckians for Nursing Home Reform to act, Gov. Steve Beshear asked his secretary for the Cabinet for Health and Family Services to head up an investigation.

Secretary Janie Miller came up with a 52-page report. One of the recommendations was a refurbished elder-abuse committee to replace the former one that had done nothing. That committee is at work now, and its mission is to find and push for the action necessary to improve care in all the facilities.

But how about the Kentucky General Assembly? It has been asked for seven legislative sessions to pass a law that would set minimum staffing standards for nursing homes. The bill has never even gotten out of committee. The fault here lies with the committee chairs and their bosses, the House and Senate leadership.

It's doubtful nursing-home reform advocates will ever have enough clout — money and otherwise — to beat the nursing home industry at its game. It will take instead strong public opinion on the side of nursing-home reform.

One of these days, public opinion and the demographics of an aging state population are going to bite the politicians who have refused to do something about elder abuse. In fact, this whole problem is waiting for us to solve it. All of us.

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