A Times Herald Record article printed on Feb 10 2022 reported on a complaint filed by a family regarding their father’s care in a nursing home in upstate New York. While there are approximately 90,000 older adults in the 600 nursing homes in New York State, the complaints voiced by the family in this particular home are unfortunately similar cries heard from families in the over 15,000 nursing homes around the country. Many of the complaints are related to understaffing. Research by thought leaders and public policy experts alike support the premise that understaffing yields lower standards in quality of care. It’s no secret that 70% of US Nursing Homes are owned by for-profit chains and it is with these chains that research finds the most egregious levels of staffing that contributes to poor care.
In January of this year, New York State Governor Hochul issued reforms to boost staffing in nursing homes by requiring ownership to spend at least 70% of their income on patient care and reduce their profit margins to 5%. Despite pending lawsuits against facilities where inadequate staffing is the culprit for neglect and poor care, the article reports that owners of 240 homes are fighting back against these reforms, a tell-tale sign that the profit motive exceeds the desire to provide higher standards of care.
The article continues to state that despite lawsuits filed against specific facilities in 2018, families are frustrated at the slow pace at which cases literally crawl through the system, some of which have still not been assigned a court date. There are underlying reasons for delays in complaints being investigated. Firstly, the system is a government bureaucracy logjammed with large numbers of filed complaints. Additionally, the Department of Health oversight system has been long criticized for its ineffectiveness and lack of substantial punitive measures taken against facilities who violate the public trust with ineffective care. Fines often amount to little more than a slap on the wrist which do not seem to be sufficiently motivating factors for changing the way care is delivered. Furthermore, ownership has lawyers on retainer who handle these matters; therefore, the facility pays the fine and continues with business as usual. Care for the individual gets lost in the process.
It is entirely likely that this story and those similar, have been repeated in nursing homes around the country. What do we have to do to have our elders receive the quality of care and quality of life they deserve?
It appears that relying on government bodies such as the Department of Health will not the solution expected to bring about change. Exposure and loud voices are likely better avenues. Said best by Supreme Court Justice Brandeis who wrote in 1913: “the wickedness of people shielding wrongdoers & passing them off (or at least allowing them to pass themselves off) as honest men.” He then proposed: “If the broad light of day could be let in upon men’s actions, it would purify them as the sun disinfects.” and went on to say that “Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants.”
Publicity involves bringing attention through major media channels: Newspapers, TV, radio, whoever and wherever the story can be told and to whomever will listen. The time for change is now, as 10,000 baby boomeres are turning 65 each and every day until 2034, and by the year 2035 the US Census Bureau predicts the population of those over the age of 65 will likely outnumber the population under the age of 18. Is this the quality of care we deserve? Is this the quality of care we will accept?
Recognizing nursing home ills and the growing demographic of older adults, Governor Hochul in her January 2022 State of the State address committed to making New York a Better Place to Age by advancing the following initiatives:
· Establishing a State Master Plan for Aging, "creating a blueprint of strategies to ensure that older New Yorkers can live fulfilling lives, in good health, with the freedom and independence to age in place for as long as possible."
A $10 Billion Investment in Healthcare and Support Wages for Workers, this investment $500 million multi-year investment includes Cost-of-Living Adjustments (COLAs) to help raise wages for human services workers and $2.2 billion on initiatives to strengthen the home healthcare workforce allowing persons who want to age in the place of their choice as long as possible.
Advance health equity by supporting nursing home conversions to the Green House model, studying the impacts of COVID on the Long-Term Care Ombudsman Program, and expanding the current programming of the State Office for the Aging to more New Yorkers.
Once again, it is not only for us to wait for government bodies to commit to alternative care models. It’s up to the public at large to educate themselves in the alternatives and begin to insist on those levels of care.
What is the Green House Model? The Green House model is a more dignified alternative to the traditional institutional style nursing home that most of us know. Developed by the visionary geriatrician Dr. Bill Thomas, the green house model is an alternative concept that would offer long-term care living environments that return control, dignity, respect, quality care and a greater sense of well-being to elders while simultaneously providing quality and personalized care.
Green House Homes are small, their interior design, organizational structure, staffing patterns and methods of delivering care offer an environment that truly resembles a person’s home. Residents live in private rooms, have a greater sense of autonomy, and are involved in decisions about their daily care, interests, and activities. There is a true sense of purpose restored to people living in Green House Homes. There are presently approximately 300 Green House Homes spread across 32 US states. All reports indicate that older adults living in Green House Homes are happier and healthier. Post COVID reports indicate the incidence of COVID-19 amongst residents in Green House Homes was far lower than for those residents living in traditional nursing homes.
Let’s not wait for government bodies to explore the possibilities of converting our nations nursing homes to more dignified living environments. Let’s become advocates for change insisting that we want and need better.
The time for change is NOW!!!
For more information on Green House Homes visit: www.greenhouseproject.org
To learn how to advocate for change and insist on better care in a nursing home email: email@example.com