After Years In A Coma, U.S. Senate Committee on Aging Shows Sign Of Life
After Years In A Coma, U.S. Senate Committee on Aging Shows Sign Of Life
Members say nursing home oversight system in "crisis" due to stagnant funding for state inspection agencies and chronic staffing shortages.
After Years In A Coma, U.S. Senate Committee on Aging Shows Sign Of Life
One out of nine of the nation’s 15,000 certified nursing homes has not received a comprehensive onsite annual inspection in two years.
Infrequent annual inspections predictably lead to more complaints, which gather dust because of the lack of state inspectors to investigate them.
As a result, the 1.1 million people who reside in nursing home are at risk, according a Senate Aging Committee report released Thursday, Uninspected and Neglected: Nursing Home Inspection Agencies are Severely Understaffed Putting Residents at Risk.
For years the Senate Committee on Aging has had little, if any, impact on the problems facing older Americans. It was irrelevant during the devastating COVID pandemic that ripped through nursing homes like a pernicious tornado, killing tens of thousands of older Americans as a direct result of poor infection control and staffing issues.
The release of Thursday’s report reflects a positive step for the Committee, which was once one of the most active in the Senate.
The Committee report found that 32 state agencies have vacancy rates of 20% or more for nursing home inspectors and nine states have vacancy rates of 50% or higher. The highest rates were in Kentucky (83%), Alabama (80%) and Idaho (71%).
USAToday previously reported that most nursing home facilities who employ fewer nurses and aides than federal guidelines require are not cited by inspectors, even though decades of research has found staffing to be one of the best predictors of care quality and is critical to reducing violence and neglect.
Stagnant Funding
Aging Committee Chair Bob Casey, D-PA, said time is of the essence when a nursing home complaint is filed because state inspectors must gather evidence to prove deficiencies, like inadequate medical care.
Casey recounted the case of an 84-year old woman from PA whose leg was broken at a nursing home. A week passed before she was taken to a hospital, where she later died. The County Coroner cited neglect as a cause of death.
Officials said the lack of nursing home inspectors reflects stagnant federal and state funding for state agencies that provide nursing home oversight. They said funding was relatively flat from 2015 to 2023 at roughly $400 million annually.
“For too long, Congress has failed to invest in strategies to protect the nation’s 1.1 million nursing home residents,” said Casey.
Nursing Shortage
Mike Braun, R-IN, the GOP ranking member of the committee, said part of the problem is a chronic shortage of nurses to provide care in nursing homes.
He said Indiana removed limits on nursing school enrollment due to a law championed by Ivy Tech Community College and the Indiana Hospital Association. Additionally, Ivy Tech additionally partnered with nursing homes to offer paid apprenticeships for college students. Braun said high schools should offer students the opportunity to earn certified nursing certificates.
Federal and state expenditures to nursing homes through Medicare and Medicaid totaled $94 billion in 2022 ($56 billion under Medicaid and $38 billion under Medicare).
Approximately 1.2 million people resided in more than 15,000 certified nursing homes in July 2022.
In testimony submitted to the committee, Erin Bliss of the U.S. Dept. of Health and Human Services Office of Inspector General, said an “alarming number of nursing home residents are subject to low-quality care and unsafe conditions.”
Bliss said the COVID-19 pandemic and its devastating impact on nursing home residents “brought to the forefront known and new nursing home challenges, including staffing shortages and poor infection control.”