Tag Archives for U.S. Department of Health and Human Services

Staffing Crisis Hits Nation’s Nursing Facilities

Published in the Pawtucket Times on February 25, 2002

A yet-to-be released federal report paints a very bleak picture about the quality of care provided in the nation’s nursing facilities.

According to an article published last week by The New York Times, a draft federal report finds that 90 percent of the nation’s nursing facilities do not have enough nursing staff to properly care for their residents.

Simply, put, the lack of staffing reduces the quality of care provided in nursing facilities, increasing the incidence of bedsores, falls, malnutrition, weight loss, urinary tract infections and blood-borne infections, the report notes.

According to the draft report, which was ordered by Congress, is expected to be officially released by the U.S. Department of Health and Human Services in April, reaching appropriate staffing in nursing facilities would cost the federal government big bucks.

With a $ 7.6 billion annual price tag, about an 8 percent increase over current expenditures – the report – entitled “Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes” – recommends cheaper ways to fix the staffing crunch in the nation’s facilities.

Rather than regulate minimum ratios of nursing staff to residents, the report calls for better management techniques and training of certified nursing aides CNAs) to increase staff productivity and to decrease CNA turnover. Additionally, market demand sparked by an informed public that has access to publicly reported nursing staff data may even increase nurse staffing levels in facilities, the report notes.

The New York Times article does not get to the root of the nation’s staffing problems in nursing facilities, charges Al Santos, executive director of the Rhode Island Health Care Association, the state’s largest trade group that represents nursing facility providers.

“While the article only focused on the inadequacies of staffing levels across the country, it failed to report on its cause – a lack of adequate government reimbursement for nursing facility care,” Santos said.

Santos stated the federal report, which is detailed in the New York Times, is correct in its assessment that the shortage is “likely to become worse.

It should come as no surprise to policymakers that in order to increase wages and to make frontline nursing jobs competitive. Medicaid can no longer pay roughly $ 4 per hour, per patient for shelter, meals, labor costs, special care, certain therapies and other items,” Santos adds. “Costs far outweigh government reimbursements for patient care, and chronic under-funding of Medicaid directly impacts staffing.”

There is no doubt in my mind that the lack of adequate staff in facilities create poor quality of care,” says Roberta Hawkins, executive director of the Alliance for Better Long-Term Care, who also serves as the state’s ombudsman on nursing facility issues. Hawkins said she fears that the continuing staff shortage in Rhode Island facilities will chip away the past 25 years of improved resident care that has resulted from state and federal nursing facility reforms.

Although inadequate pay and benefits are obstacles to retaining staff, Hawkins predicts that it will become even more difficult to recruit CNAs when more horror stories about poor care appear in local newspapers or on state or federal agency websites.

“As a society, all of us are responsible for the care not being provided to nursing facility residents. If we don’t provide that money to pay for the best of care, we are partially responsible for that care not being provided,” Hawkins said.

Hawkins sees as permanent fix to this ongoing staffing shortage found in Rhode Island facilities – tie the reimbursement rate to the level of resident care provided. For instance, facilities with heavy-care residents would receive a higher Medicaid reimbursement rate, which takes into account the increased staffing needs of those residents.

But adequate Medicaid funding is not the only solution to the continuing staff shortage dilemma facilities face, Hawkins warned.

“We need to create upward mobility in nursing jobs, improve training specialty care provided to Alzheimer’s residents, bedridden residents and to those requiring rehabilitation,” she said.

The new federal study doesn’t surprise Lt. Gov. Charles J. Fogarty, who chairs the state’s Long-Term Care Coordinating Council (LTCCC) and to those involved in providing or regulating nursing facility care in the Ocean State.

Just last year, a statewide LTCCC study found Rhode Island’s nursing facilities reported a shortage of certified nursing assistants, the staff who provide 90 percent of the direct care to residents.

“The report gives us useful information to look at the issue of staffing and quality in Rhode Island nursing facilities,” Fogarty said. “It also should serve as a clear signal to Congress that it must do a better job of planning and funding long-term care.”

A state commission chaired by Human Services Director Jane Haywood, is currently studying how the existing Medicaid reimbursement system can be improved.

Even with a mounting state budget deficit, it is now time for the governor, state lawmakers and state officials to put the energy and resources into tackling this ongoing staff shortage issue.

With major input from the nursing facility industry and from Hawkins and her resident advocates, Haywood’s final blueprint for changes in the state’s Medicaid program must be taken seriously. With a state election looming in November, candidates running for governor, the Rhode Island General Assembly and Congress must do their homework, study the staffing crisis in the state’s nursing facilities, and develop their positions to confront this pressing policy issue.

More than 10,000 nursing facility residents and their families pray that the report to be issued by the Department of Human Services will not end up in some back office on a dusty shelf.

AARP Pushes Busch to Pull Rude Commercial

Published in the Pawtucket Times on July 23, 2001

Everyone knows that sex and humor are used every day to effectively advertise products, ranging from blue jeans, CDs, perfumes and colognes, to America’s youth. Now an advertising firm is seeking new outrageous ways to pitch beer for their Fortune 500 client.

Anheuser-Busch, Inc., the maker of Budweiser beer, is known for its fun and humorous commercials to sell Bud beer by using computer-generated talking lizards and young men yelling “Whassup.” But the Washington, D.C.-based AARP and senior advocates across the country found Anheuser-Busch’s new radio commercial using elder abuse to pitch its beer to be unacceptable. The nation’s largest senior advocacy group, representing 33 million older Americans, called the radio ad portraying a young woman abusing and exploiting her elderly infirmed husband, “offensive” stating that it just goes so far.

In “She Married Steven Buck Simpson,” a young woman gleefully talks about how she is physical, emotionally and financially abusing her frail elderly husband. Here’s the text for the commercial spot describing the abuse intergenerational relationship:

“Last year I married oil tycoon Steven Buck Simpson. He was 93. I was 22. And it was true love, hmm, or so I led him to believe until the wedding. After that, I fired his lawyer and cardiologist. I let his house insurance lapse, alienated him from his children, and sent him out for a walk so I could get freaky with the pool boy. Umm, I deflated the tires on his wheelchair, soaked his dentures in turpentine, and hid his oxygen.”

“Let’s see. I replaced his blood pressure medication with Red Hots, fed him high fat, high cholesterol foods. And finally, liquidated 100 percent of his assets into a Swiss bank account, dropped his dog King off at the pound, and left the country in his private jet, where I promptly renewed my membership in the Mile High Club.”

At this point a m  a states, “Ooh, ooh man that’s cold!” With the sound of a cap being popped off a beer bottle, an announcer responds, “But not as cold as Bud Ice. Ice brewed for a smooth crisp, refreshing taste. Bud Ice, there ain’t nothing colder. Anheuser-Bush.” Quite a way to sell a brand of beer.

When the commercial, playing in several markets, caught the attention of AARP the group’s president Esther Canja, wrote to CEO August A. Busch III of Anheuser-Bush, informing him of her disappointment that the beer company would “make light” of the very serious aging issue of elder abuse.

“Elder abuse is not a joking and your message to the contrary is most inappropriate.” Canja bluntly told the CEO noting that the incidence of elder abuse is increasing at an alarming rate. She cited a National Elder Abuse Incidence Study that estimated that 450,000 older persons are abused or exploited each year.

“While humor has its place, your ad goes to far,” Canja said, urging Busch to withdraw the offensive ad from the marketplace. “You certainly would not sponsor a commercial that portrays a parent physically abusing a child or even mistreating a family pet,” she added.

In Rhode Island, senior advocates were also incensed about Anheuser-Busch’s radio commercial. “This ad, which is so corrosive to the well-being and dignity of our seniors, crosses the boundary from humor to just plain bad taste,” Kathleen S. Connell, AARP Rhode Island director, told the Times. “I join AARP President Esther Canja in calling the company to scrap this piece of junk,” she said.

Adds Rhode Island Ombudsman Roberta Hawkins, of the Alliance for Better Long-Term Care, the Anheuser-Busch commercial is unacceptable.” The well-known Rhode Island senior advocate stated that elder abuse, although not publicly acknowledged by the media, is a widespread and a tragic problem. “If you spent your days the way we do listening to horrible situations just like the ones you think are so funny, your opinion of this commercial would change,” she added.

An e-mail writing campaign initiated by Bill Benson, a former deputy assistant secretary for aging at the U.S. Department of Health and Human Services and president of the Maryland-based Benson Consulting Group, during his July 13 Washington Radio Report, has finally caught the attention of the St. Louis, Mo-based beer company.

Benson e-mailed his weekly radio report, “This Bud’s Not for You” to hundreds of his colleagues informing them about the offensive commercial. Word spread like wildfire across the Internet. After numerous attempts to contact Anheuser-Busch, the company finally responded with a written statement. Bill Etling, a spokesperson for the company stated, “It is never our intention offend anyone with our advertising. Anheuser-Busch has discontinued use of this ad and has no plans to use it in the future.”

As the dust settles after Anheuser-Busch’s recent public relations fiasco. Benson hopes that the beer company will reexamine who they choose to write their advertising. “I am sure that they are clueless about how people would react. I bet you this is the last time that Anheuser-Busch uses radio advertising to take jabs at vulnerable seniors,” he says.

“It is clear that the combination of senior advocates and the use of the Internet to spark an e-mail writing campaign nipped Bud in the Bud,” Benson said.