Two years ago, the Legislature passed a caregiver-staffing requirement that would improve direct-care ratios to prevent resident neglect and unsafe working conditions for caregivers. But like many laws, it hasn’t worked quite as intended, and staffing levels in our nursing home are still inadequate to protect quality care
There are more than 70,000 seniors in King County and the number only keeps growing. The Legislature must continue improving Washington’s nursing homes by raising caregiver-staffing levels. As a certified nursing assistant (CNA) who’s worked in nursing homes for the past 20 years, I know first-hand that more staff is needed to allow caregivers to meet the physiological, mental and physical needs of each resident.
The best step forward is for the Legislature to use any additional state funding for nursing homes to lift the caregiver-staffing requirements and remove loopholes that prevent it from working properly.
The official language is “Caregiver Hours Per Resident Per Day,” or HPRD, which is now at 3.4 per diem. But this number includes administrative-staff hours, meaning staffers who don’t provide direct care to residents. As a result, certified nursing assistants and caregivers are still finding themselves in situations where there is not enough staff to meet residents’ needs.
Increasing the requirement to 4.1 caregiver hours per day, the staffing level recommended by the federal Centers for Medicare and Medicaid Services is a practical solution to fixing these types of situations.
Many residents at nursing homes suffer from serious medical conditions that require specialized direct care. Right now, CNAs can still have up to 16 residents who need care, which means not everyone gets the quality care they need or deserve.
Nursing-home staffers have all had residents who either receive too few visitors or have no living relatives. It’s situations like these when having more staff would make a real difference in people’s lives. This one-on-one time from caregivers is the difference between just being kept alive and leading a good life. At times, I have heard my fellow caregivers express fears about not being there when a resident with no family or friends dies.
These are not just my observations and experiences. Studies have shown that an increase in hours of daily care yields benefits ranging from better health outcomes for residents to fewer injuries for direct-care providers. The Legislature would be wise to increase the HPRD in Washington’s nursing homes.
Washington state made significant gains when daily care hours were increased to 3.4 per resident, but we still have a long way to go. The Legislature can help ensure quality care for residents if they set a better standard and increase the current minimum.
Linda Long is a certified nursing assistant and community advocate who lives in Kent.
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