Advocates push for Safe Staffing Act in Albany
ROCHESTER — Every day, a lack of skilled medical care costs people their lives in America.
According to a recent study by Johns Hopkins, more than 250,000 people in the United States die every year because of medical mistakes, making it the third leading cause of death after heart disease and cancer. Up to 100,000 of those mistakes are linked to slowed responses due to lack of staffing.
In the Finger Lakes and Southern Tier, one watchdog group hopes to make progress in the number of deaths resulting from medical emergencies not caught in time due lacking staff at the 600-plus acute care and nursing facilities around the state.
Elder Justice, a committee of Metro Justice, seeks to transform nursing homes from hospital-like holding institutions into meaningful and nurturing homes where elders can continue to live truly fulfilling lives. It aims to find ways to eliminate elder abuse, neglect and exploitation, its website says.
The Rochester-based organization meets monthly at the Pittsford Library, and invites seniors and their loved ones to join and learn how to be an advocate.
As part of its mission, Elder Justice compiles lists, ranking elder and rehabilitation care facilities; alerts government oversight officials to issues; tracks the latest regulations; and trains caregivers on how to demand the best for their loved ones.
"In a lot of the nursing homes, one has to go every day, or 3-4 times a week and make your presence known so the staff will make sure the person is fed and that the call bell is responded to. You get better care if there's a relative around," said committee co-chair Barbara Baer.
At the center of the group's advocacy currently, is the Safe Staffing Act, a bill in front of the New York State legislature, that would set minimum direct-care nurse to patient ratios in acute care or nursing home settings.
On Monday, a database of staffing levels at all nursing homes in the U.S. went live at www.nursinghome411.org, made available by the Long Term Care Community Coalition (LTCCC). Their analysis of data from the Centers for Medicare and Medicaid Services indicated that US nursing homes provide an average of 3.4 total care staff hours per resident per day and an average of .5 RN care staff hours per resident per day — far less than federal recommendations.
In many cases, RNs are replaced with LPNs and Aides who make far less money, further reducing the quality of care at some facilities.
The Safe Staffing Act would require 4.1 hours of care staff time and at least 45 minutes of RN care staff focus for patients.
"This is just one drop in the bucket compared to what is needed, but at least it's one piece of legislation that could pass and do something about minimum staffing," Baer said. "At least the hands on staff would have to spend some time with you and that relates to better care."
Of six nursing facilities tracked in Steuben County by LTCCC, none met the minimum standards that would be set by the Safe Staffing Act, two met the national average of .5 RN hours, and none met the national average for total care staff hours. None of the four facilities tracked in Allegany County met those standards either.
The hands-on care time was deemed inequitable by Elder Justice, especially given what is spent on care. Nursing homes get between $100,000 and $120,000 per year, per Medicaid patient, and independently determine how much they may profit, a consideration Baer says is at the root of the staffing issue.
"They're being bought up by for-profit corporations, and New York State doesn't closely examine who's buying them. It's easier to buy a nursing home than a liquor store," she said. "The people who buy them are often never there, the owners constantly change, and for them it's not a mission or a call to duty, it's just business."
Elder Justice Advocate Mary Ann Sprung, a retired RN, has 40 years of experience in healthcare, educated nursing students, has acted as a caregiver for a nursing home resident and has seen service at a rehabilitation facility first hand.
"Quite frankly, I'm appalled by staffing levels. I've always wished that New York had a Safe Staffing law ... Nurses work extended hours and in a system that is often antiquated, even at the highest rated facilities," she said. "The ability to immediately triage a situation is essential, when call lights or calls for help go unanswered, people die. Low staffing is a problem across the board."
The Safe Staffing act seeks a ratio of patients to direct-care nurses of 4 to 1.
The bill would also give nurses the right to refuse any work that violates the minimum staffing requirement without retaliation, helping otherwise compassionate people keep from experiencing a burn-out.
Several other states like California, already have similar laws on the books.
On the other side of the argument, facility owners argue for the status quo, saying that more employees mean higher healthcare costs for the seniors under their care.
"Unfortunately healthcare in America is big business, and the number one priority is not always quality patient care, it's money. Because money is the bottom line, staffing is kept at a bare minimum, especially nights, weekends and holidays," Sprung said.
Organizations like Elder Justice hope to build a critical mass of nurses, patients and caregivers to convince legislators to back the Safe Staffing Act. Baer said that the areas legislators have either voted against the measure in the Assembly, or have not signed on to support the bill in the Senate.
The organization encourages area residents to call their respective senators and ask them to support the Safe Staffing Act. Elder Justice is also circulating an online petition in support of the Safe Staffing Act.
To learn more about Elder Justice and their advocacy work, visit www.metrojustice.org/elder_justice.