America’s Broken Nursing Homes: Does Anyone Care Enough to Fix Them?

Posted on behalf of Jeff Pitman on March 9, 2021 in Nursing Home Abuse
Updated on April 24, 2024

elderly woman in wheelchair unattendedThe COVID-19 pandemic of 2020 took an unprecedented toll on nursing homes across the United States. More than 170,000 long-term care residents and their caregivers died after becoming infected with the virus.

In addition to the massive loss of life, COVID-19 magnified the ongoing care issues that continue to exist in nursing homes. Today, it is clearer than ever before that long-term care is critically broken.

Robert Kramer, founder of Nexus Insights – a long-term care consulting firm, told NBC News, “The system is broken. COVID didn’t make it dysfunctional, but COVID showed that it was broken and dysfunctional.”

What are the Biggest Ongoing Challenges in Long-Term Care?

The issues today are much the same as they have been for years and include:

  • Staffing shortages
  • Risky work for low wages
  • High turnover of staff who feel undervalued and are tired of bad working conditions
  • Lack of transparency and accountability by the facilities
  • Lack of oversight

Additional challenges arose during the pandemic that further impacted the spread of the virus, such as:

  • The ability to gain an adequate supply of personal protective equipment (PPE)
  • Too few staff trying to manage the care of residents who were isolated
  • Staff working multiple facilities to help make ends meet who then became super spreaders of the virus as they went from one nursing home to another.

The combination of these issues significantly impacted the already poor quality of care that residents received.

Multiple studies revealed that nursing homes with more caregiver hours per resident had fewer fatalities from COVID-19 and smaller outbreaks. But by December 2020, more than 30 percent of long-term care facilities reported additional shortages of nursing staff and aides.

How Are Nursing Homes Funded?

Most nursing homes are primarily funded by two different sources – Medicaid and Medicare. While Medicare, which provides health insurance for older Americans, gives larger payments for short-term care (up to 90 days), Medicaid is publicly sponsored insurance for low-income Americans. Medicaid payments are significantly lower than payments provided by Medicare.

Since elective surgical procedures were discontinued during much of 2020, Medicare payments dried up. This left many facilities struggling to stay afloat, while others simply went bankrupt. Many advocates believe the pandemic is clear evidence that this current business model does not work.

COVID-19 Relief Funds

To help support these struggling nursing homes, Congress designated significant relief – $21 billion in funding. While this funding was meant to help make up for some of the lost revenue, there was little oversight attached to the funds. Long-term care facilities were mostly free to spend this money as they saw fit – even to cover other overhead costs, such as lease payments for medical equipment, and facility rent or mortgage payments.  Now, questions are being asked about where that money was used.

Opportunity for Change

The never-before-seen focus on the health of America’s nursing homes has created a once-in-a-generation opportunity to target the serious issues in long-term care and implement real changes. Even the public is taking notice amid the pandemic. The question is: Will it trigger any significant change?

Advocates for elderly care, including researchers, consumers and lobbyists, are concerned whether the funding nursing homes received is actually being directly invested in the care of residents. They want federal lawmakers to force for-profit nursing home chains and other long-term care facilities to reveal where the money is being spent before any more funds are provided.

Kezia Scales, director of policy research for PHI, a research and advocacy group for nursing home care workers, states that, “We need more transparency around where money is going – and to what extent it’s being invested into jobs and quality of care versus profits.”

Proposed Changes

Advocates are also proposing multiple changes to help repair what is broken in the industry.

Current discussions include:

  • Increasing wages for nursing home caregivers
  • Strengthening federal staffing standards – including the minimum hours of care per patient
  • Incorporating a medical loss ratio to limit the percentage of revenue nursing homes can spend on administrative costs and profits – already passed and implemented in New Jersey
  • Expand benefits beyond Medicaid

The Biden administration is also promising changes to improve the current state of nursing home residents and the staff providing their care. Promises from the White House include, helping nursing home staff “who are long overdue for policies that value the dignity of their work.”

Realistically, any such policy is not likely to happen quickly, with so many other legislative priorities already crammed into a limited window.

Illinois congresswoman Jan Schakowsky warns that neglecting to address these well-known issues, will only lead to further cases of gross neglect, abuse and premature death in our country’s nursing homes.

Contact PKSD Law for Legal Help

If your loved one has suffered illness or injuries due to gross neglect in his or her nursing home, our firm is prepared to help.

Our experienced nursing home abuse attorneys in Wisconsin are deeply committed to protecting the elderly and holding at-fault parties accountable for actions that cause them harm.

Call our law offices to learn more. Our initial consultations are completely free and there is no obligation to pursue a claim.

PKSD Law. We are here to help you. 414-333-3333

Back to top