Governance by Anecdote Is Alive in Washington, D.C. – Guest Columns

Brendan Williams

In a Press release warning of “disastrous conditions in chains of for-profit nursing homes in 2020”, the select subcommittee on the coronavirus crisis cited care problems in about a dozen nursing homes out of the more than 15 000 nationally to make his point.

I would never excuse negligence, but a few cases involved PPE shortages at a time when PPE was notoriously unavailable. One example referred to an establishment that resorted “until May 8, 2020” to “makeshift isolation gowns”, which I can attest to by having my association itself try to extract from such blouses from China, was understandable.

If I were to borrow the Committee’s stupendous wording, “no later than July 1, 2020,” I was quoted in a national Associated Press newspaper article about the “trash bag” isolation gowns the federal government had sent to nursing homes, saying: “There is no way a provider is forcing a caregiver to the indignity of wearing a trash bag. Things are already bad enough.

According to the Committee, an “anonymous individual” said staff at a nursing home had to wear the same masks for several days in a row, but it must be remembered that the shortage of masks was such that the Joint Commission for Hospitals issued a public statement “allow staff to bring their own face masks or standard respirators to wear at work” and noted CDC guidance that “[i]In settings where face masks are not available, healthcare personnel (HCPs) may use homemade masks (e.g., bandana, scarf) for care of COVID-19 patients as a last resort.

These were desperate times. Has the Committee overlooked that or the federal government’s own culpability? “No later than July 24, 2020” I have provided photos for a New York Times article on the faulty masks that the federal government has sent. And I have maybe a dozen boxes of face shields in my association’s storage room if anyone wants them, because we ordered them for members when it was the shortage of the day.

The Committee’s lascivious interest in for-profit facilities neglects all government run facilities that had big problems dealing with an unprecedented virus, or a certain disgraced New York governor turning his state’s nursing homes into killing fields, a tragedy that hasn’t deterred politicians who are lined up to praise his “leadership”. But putting that aside, I can’t see how anyone can initiate anecdotes of the worst possible time for our entire health care system in an argument to increase nursing home staff at a time when staff is not available. But some want it.

More than half of nursing homes in New Hampshire, in a state with a 2% unemployment rate, are understaffed according to an AARP metric. I know of county-run facilities with waiting lists of over 100 residents that balance the demand for care and the need to prove it responsibly. Private facilities are in the same boat.

Is the staff shortage for lack of trying? According to a study we commissioned from a regional accounting firm, between 2019 and 2021, New Hampshire nursing homes saw their payroll costs increase by 20% excluding staffing agencies, and salaries have been rising ever since. However, it is of no use.

Recently, many establishments have detailed their fate to the state. Consider a nonprofit with 32 full-time nursing positions open that spent $253,022 on staffing agencies last month and, perhaps not coincidentally, lost $208,000 that month. They cannot rely on staff to fill their beds. It’s a closure recipe. Our state had to award a $7.6 million contract with a California recruiting agency to its own veterans’ home because the facility was operating half-empty and couldn’t find staff, even with the salaries and benefits. higher than the state can provide.

A federal government that blames and punishes an entire health sector for the alleged transgressions of a few actors is an inadmissible idea. But, again, inequity has long defined government treatment of our most vulnerable citizens and those struggling to care for them.

Brendan Williams is president and CEO of the New Hampshire Health Care Association.

The opinions expressed in McKnight Long Term Care News guest submissions are those of the author and not necessarily those of McKnight Long Term Care News or its editors.

Helen D. Jessen