Biden's nursing homes proposals could help address problems highlighted by Arizona Republic series

Shortages of caregivers at Arizona’s nursing homes have resulted in innumerable injuries of both residents and staff members, a year-long investigation by The Arizona Republic and azcentral.com found.

That’s what President Joe Biden said he wants address across the country in a proposal announced on Friday that includes minimum staffing levels at every tax-funded nursing home.

“Despite nursing homes receiving nearly $100 billion annually from American taxpayers, too many facilities are understaffed, which can result in severe illness and even death for residents,” Biden said in an editorial for USA TODAY.

“Those vulnerabilities were exposed during the pandemic, when more than 200,000 nursing home residents and workers died from COVID-19. And in recent years, more private-equity firms have been buying up nursing homes and slashing key staff to cut costs and make bigger profits, endangering the safety of their residents in the process.”

But at least one critic believes Biden is not going nearly far enough.

The problems Biden is seeking to address were documented in a series of Arizona Republic articles about how vulnerable seniors, particularly those with dementia, contend with violence at the end of their lives and how shortages of staff — often resulting from companies looking to maximize profits or stave off financial losses — lead to more harm.

At Gardens Rehab and Care Center in Kingman, for example, an employee got hurt in August 2019 after trying to shower a resident by herself — a resident who was supposed to have two employees assisting him with such functions. There just weren’t enough caregivers available that day and the man ended up punching and kicking the woman and throwing his underwear in her face.

The Republic found that the overwhelming majority of senior living facilities across the country were understaffed and that researchers said that was the way they chose to operate.

Companies often sought to increase profits by reducing staff, but when that happened, it put both residents and staff in danger.

Biden’s proposal is a first step toward solving staffing problems at nursing homes across the country.

One piece would require nursing homes to have a registered nurse on site 24/7 and enough nurses and nurse aides to provide routine bedside care.

“Research shows that these staffing levels will save lives, provide residents with a higher quality of life and prevent needless suffering,” Biden wrote in his editorial.

At the same time, Biden said the U.S. Department of Health and Human Services is investing $75 million to recruit, train and retain nurses and other caregivers.

He added that his administration has already increased transparency for nursing home owners and has gone after fraud and abuse.

“As a country, we’re delivering a clear message to the nursing home industry: no more padding profits on the backs of residents and nurses,” Biden said. “If you tell families you’ll take care of their loved ones, then follow through.”

AARP Executive Vice President Nancy LeaMond expressed her support for the president’s initiatives.

“COVID-19 revealed what AARP and other advocates have been saying for decades: the lack of standards and poor-quality care in too many of America’s nursing homes is deadly,” LeaMond said. “Far too many Americans died in those facilities, which have been plagued with problems for many years. Today’s proposal is an important step to establish a minimum nursing home staffing standard.”

Critic sees 'big disappointment'

But Charlene Harrington, professor emerita of sociology and nursing at the University of California-San Francisco, said the proposals were a “big disappointment.”

“They weren’t based on the research,” she said, “but on a compromise with the nursing home industry.”

Having a registered nurse 24/7 at nursing homes was something that Harrington had called for. She also liked the idea that the Biden administration was calling for more transparency in Medicaid cost reports and that 85% had to go toward on nursing, therapy and food and not administrative costs and profits.

But Harrington said the Biden administration should have set higher staffing levels for nursing assistants and for caregivers overall.

Another drawback of the president’s initiatives is that they do not address staffing at assisted living facilities, which do not receive Medicare and Medicaid funding. There are about 140 nursing homes in Arizona and 300 assisted living facilities.

How the system enables violence: At an Arizona senior living center, a resident killed another

The Republic found that many injuries in senior care locations happened at assisted living facilities.

At Heritage Village in Mesa, for example, there weren’t enough staff on duty to prevent a troubled resident from going on a rampage and punching two other residents, eventually causing a caregiver to hide in a bathroom with one of the injured residents until the police arrived.

"It was just two of us ladies. We couldn't really deal with him," said Margaret Ndwiga, one of the caregivers. "Maybe if we had more, or the right kind of people."

This article originally appeared on Arizona Republic: Biden nursing homes staffing proposals could help problems in Arizona