Nursing home residents are subjected to ineffective care and poor staffing, while facility finances are shrouded in secrecy and regulatory lapses go unenforced, according to a report that called for wholesale changes.
The report covers a vast cross-section of long-term care, from granular details such as the way facilities are designed to foundational issues that would require massive political capital and investment to address. Among them: The authors advocate for creating a new national long-term care system that would exist outside of Medicaid, the program that is at the center of most long-term care financing.
Katie Smith Sloan, who leads LeadingAge, which represents nonprofit nursing homes, called the report “a piercing wake-up call” about an industry “in desperate need of an overhaul.” The success of remaking the system, Smith Sloan said, would depend on how the government addresses funding. On the issue of nursing home staffing, which advocates have repeatedly said is too low, too untrained and too underpaid, the report's authors called for facilities to have at least one registered nurse on duty at all times and for an infection prevention and control specialist and social worker to also be on staff.
Among the more routine subjects in the report, but one that nonetheless impacts residents' everyday lives, the authors call for homes to prioritize private rooms and bathrooms instead of the communal ones that can fuel infections and underscore the institutional setting. And in a blunt reminder of how bleak life in nursing homes can be, the report notes most residents spend “little if any time outdoors," calling for facilities to make outside access more accessible.
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