I have direct experience with how this industry operates. The government regulates them fairly strictly and States perform audits on a routine basis. The homes are frequently horrific in how they care for our elders and chronically ill. This is not to say there aren’t many dedicated professionals that work in the industry that do care a great deal.
This is where the problem arises. The folks with direct input into what needs to happen to provide better care are never heard. I was part of a CMS funded study to track the reasons for hospitalizations and found during this work, and industry grounded in old-world philosophy unchanged by progress. The staffing is poor and the working conditions are typically brutal for the caregivers. Don’t blame them. They offer solutions but have no one to listen to them.
They are considered in most cases to be “skilled” nursing facilities, which typically means they have few registered nurses that provide direct patient care, instead rely on poorly paid, poorly trained caregivers that have a high percentage turnover. Higher standard of care means better qualified, better paid tenured staff.
When the current pandemic broke out we were aware of who the most vulnerable were and mobilized the military and asked for help in hardest hit areas. Where did all this manpower go? Certainly not directly to the nursing homes to help with the protection of the elderly.
To compound the issue, the practice of sending sick elderly to the hospital on a routine basis is dangerous. Hospitals are where the germs are. This was proven when they were returned in many cases positive with COVID. In some cases, ill folks in these homes can be treated in the skilled nursing homes, but they lack the support to do so. Administrators of these facilities have no choice but to send these folks to a hospital any time they get sicker than they already may be, for fear of the lawyers lurking for a 30-40 percent take of a lawsuit. Thereby increasing the cost to operate these homes.
Remember, the latest pandemic did not originate in these facilities but it certainly laid waste to many who were vulnerable for no reason. This could have been prevented. Agencies have failed us. Again.