Ok, what can I say? I've been saying that little rhyme for years, and I couldn't resist it. But as I as stop to think about it for a moment, I hope that May is full of flowers. We need to look at something lovely. It will help distract me for just a few minutes and soften the very deep concern I have and sadness I feel for what is happening inside our nursing homes.
It used to be that once in a while I would hear a story about an older person being neglected or receiving poor care. Lately, it seems like a daily event. For years, I've known and have talked publically about the decline of our long-term care system, but I believe now that what may have been interpreted by some as "nay-saying" is now an horrific reality.
It's well known that much of the funding for long-term care comes from Medicaid. In our current economic crisis, funding for Medicaid is receiving increasing scrutiny, as it should, since some 20-30 billion dollars of fraudulent Medicaid claims. This of course needs to be cleaned up. However, skyrocketing costs will probably lead to capping benefits, and/or restricting benefits. We simply cannot collect enough tax money to pay for all the long-term care that will be required.
Compounding the funding issue is the staffing issue. Staff shortages are severe and getting worse. I've seen projections for staffing shortages reaching as high as 29% over the next three decades. Currently, we are experiencing about a 9% shortage. Translated: there are about 125,000 nursing positions open.
What does this mean for the vulnerable old person who needs nursing care? At best, it is a dismal picture. Poor care, as a result of neglect,and sadly abuse is not the exception any longer. On the other side of the coin though and in fairness to the people who are working in nursing homes, nursing home workers are doing the best they can under difficult circumstances.
The average rate of pay for a nursing aide, the person who is on the frontlines, i.e., bathing, bathrooming, feeding, grooming, dressing, people, is $8.50 per hour. Jobs at fast food places pay more than that. The reimbursement rate on Medicaid invoices is 60 cents on the dollar. Translated: A nursing home loses about $15 per bed per day. If I have 100 beds in my nursing home, that's $1,500 I will lose each day. Oh, I can't forget to mention the 300% turnover rate. All of this adds up to disaster.
I've seen firsthand, great people, great workers with great work ethics, great attitudes, caring loving people, burned out after 18 months of working in a nursing home, and then like the majority of their co-workers, quit, leaving behind the frail elder who has little or no say in what is happening to them. Imagine how frightening that must be for them.
Once, during a major exodus of nursing home workers, I heard a old woman look up into the face of aide and ask: "Are you leaving too?"
Well, if I stare into this "picture" too long, I get depressed. So I need to take a periodic break and find something nice to think about, something lovely like a field of newly blossomed flowers. I really do hope for all our sakes that April showers will bring May flowers, especially to people living and working in nursing homes.
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