NC’s nursing homes are in crisis. Here’s what lawmakers must do.

I’ve been an advocate for improved conditions for residents in long-term care facilities for over 30 years and the experience of the past two years has laid bare the fundamental vulnerabilities of North Carolina’s systems of care.

Residents of long-term care facilities have borne the brunt of the ravages of the pandemic in deaths, morbidity and the impacts of isolation and loneliness brought about by restrictions placed on visitation.

As we come out of the pandemic, there are lessons learned and actions to be taken by our state leaders.

First and foremost, there cannot be quality of care and quality of life for nursing home residents without adequate staffing. Staffing shortages in N.C. nursing homes have reached a crisis point, leading to inadequate care at best and deaths of residents at worst. That is evidenced by the recent experience that lead to two deaths at Pine Ridge Health & Rehabilitation Center in Thomasville.

More nursing homes are reporting staffing shortages in North Carolina than at any other point in the coronavirus pandemic. I am heartened by the Biden administration’s call for a federal minimum staffing requirement. The current federal law is vague, requiring only sufficient staff to attain or maintain the highest level of resident well-being possible.

Many states have adopted minimum staffing requirements. Unfortunately, North Carolina is not one.

We shouldn’t wait for the federal government.

Research shows that 4.1 hours of nursing care and RN coverage 24 hours a day are needed so that residents do not decline. In the absence of a minimum staffing requirement, North Carolina lags the nation in hours of care provided to residents, which leads to a higher risk of malnutrition, weight loss, bedsores, falls and infections among the residents.

But staffing issues won’t be solved by simply adopting a minimum standard. It is essential that systems be in place so that the staff are well trained, well equipped, well compensated, and respectfully supervised.

A pool of workers needs to be developed to replace those leaving the workforce and to respond to the increases in demand brought about by the aging of our population. To address future workforce needs, North Carolina needs to support the direct care workforce, address the management culture in facilities, and invest in education, particularly through our community college system.

North Carolina is participating with two other states in a project called Essential Jobs, Essential Care to develop a road map for advancing policy solutions to improve jobs for direct care workers. This project involves a multifaceted approach involving long-term care industry representatives, state government officials, and long-term care advocates. I am hopeful regarding the impact this effort might have.

North Carolina must remove the liability protections granted to nursing facilities during the pandemic. This shield has directly resulted in a cover for those who provide poor care.

North Carolina also needs to have the political will to come down hard on facilities that provide substantially poor care. We need to decertify nursing homes that demonstrate their inadequacy.

Year after year, I witnessed poor providers continue to stay open even though the care they provided resulted in unnecessary suffering and death. We know who these facilities are. There is even a category of special focus facilities, but they still operate.

Learn the lessons of the pandemic and take action.

This story was originally published March 28, 2022 at 6:00 AM with the headline "NC’s nursing homes are in crisis. Here’s what lawmakers must do.."