‘Right under our noses’: terrible conditions in nursing homes through the pandemic

The big problem is that federal and state laws (or lack thereof) allowed nursing homes to be deprived of care. They are actually called rehabilitation facilities or long-term care facilities. In Florida in 2002, CNAs of then-SEIU Local 1199 worked after which slept on a 10-hour bus ride to Tallahassee, lobbied and fought for the landmark “2.9” laws that provided a median of two.9 hours of CNA care plus 1 hour of RN or LPN care per resident per day. At that point, the typical care time was 1.4 to 1.6 hours per day. The bills became law and weren’t fully funded until 2008. Increasing staffing has dramatically improved the standard of care in Florida nursing homes. The law got here with the tort reform compromise, making it harder to sue against facilities under the philosophy that it’s higher to stop abuse than to sue over it.

Every yr since full funding, the unique bipartisan bill has been attacked by GOP leaders by limiting hours – currently 0.3.5 hours per day of combined care. Most homes have also limited the variety of RN positions to the federal minimum of 1 alongside an RN supervisor with 8 hours per day in the ability and 16 RN hours available by telephone or radio. LPNs filled the RN gap.

During the pandemic, some homes did well with infection control and isolation, but many homes issued one surgical mask per week, no N95, and didn’t even notify staff that they were caring for Covid-19 positive patients, under the pretext of violating HiIPAA. Staff and resident infection rates, in addition to deaths from Covid-19, were high, leading to staff shortages. Poor conditions resulted in a rise in resignations.

As a part of its emergency response to this crisis, the Florida Agency for Health Care Administration (ACHA), which oversees nursing homes, has allowed a new-level caregiver, PCA or patient care assistant, to finish a CNA and deductible in no less than 3.5 hours. These employees are considered under the Nurse Practice Act to be UAPs – unlicensed assistive personnel who work under an RN or LPN license but don’t have any education, training, or scope of practice requirements aside from the RN or LPN limit. As an emergency source of personnel they were higher than nothing,

The CNAs knew higher what was going to occur. As facilities receive priority vaccinations and Covid-19 case rates decline, the Florida Legislature is now introducing bills that may make PCAs everlasting and counted inside 3.5 hours, which once more threatens the standard and safety of care provided to residents nursing homes.

Gross misconduct in protecting nursing home employees through the pandemic was ultimately addressed at our facilities represented by 1199SEIU UHWE Florida by member leaders approaching management, then AHCA, then OSHA, and in some cases, the press and the communities served by the facilities. Former Governor-turned-Senator Rick Scott trashed the Ombudsman’s independent oversight program and shifted the burden of reporting problems to residents filing complaints quite than regular inspections.

I cannot imagine quality control issues in nursing homes represented by nonunion employees, given the inconsistent responses from AHCA and OSHA, and now the power to switch CNAs who file complaints or request appropriate PPE, training and isolation equipment, policy enforcement, and staff, untrained and irresponsible PCAs.

As the variety of residents and patients in nursing homes has increased over time, the reply is for CMS and HHS to extend the minimum wages for RNs and licensed caregivers nationally. Let’s put nurses back in nursing homes and let’s not allow caregivers to be less educated than CNAs, who under the Nurse Practice Act have a selected, limited scope of practice and are held accountable based on their certifications, not only someone who works under a license nurses and have minimal training, supervision and no accountability to any standards.

If you reside in Florida, call your senator and state representative and tell them you oppose HB 485/SB 1132 Patient Care Assistants.

I’m pleased with our union leaders who’ve stood up for the standard of look after their residents and standards of employee protection. They still don’t make the $15-an-hour minimum wage or have inexpensive health care because governors and party leaders in Republican-majority Florida have adamantly refused to expand Medicaid, although many Republican state senators have voted for and passed similar versions of ME.

Choices have consequences.
Governors and legislators work for us. We must hold them accountable for the security of residents and caregivers.