Inadequate and neglectful care for many nursing home residents in Illinois and across the country existed long before the COVID-19 pandemic struck. But the virus has provided a stark reminder of the shortcomings of providers.
In just over a year, 174,000 long-term care residents have died due to the pandemic, and hundreds of thousands of residents and staff members have contracted the virus. The effects of COVID-19 illustrate how vulnerable nursing homes are when a health crisis hits.
Nursing home vulnerabilities
Health care experts wondered why nursing facilities failed dramatically and quickly after COVID hit. They point to these inadequacies vividly exposed by the virus:
- Staffing shortages: Low pay and challenging work conditions lead to high turnover among frontline workers, such as certified nursing assistants. The AARP says 25% of all U.S. facilities are understaffed, and in Illinois, that percentage is even higher at 28%.
- Reimbursement rates: Medicaid covers over 60% of all nursing home residents, accounting for 70% to 80% of these facilities’ operating costs. Many nursing homes use these numbers to suggest their profits are low. However, experts say, in reality, for-profit nursing homes make excessive earnings by underpaying their workers.
- Corporate structure: Seventy percent of U.S. nursing homes are for-profit ventures. Kaiser Health News says many of these large companies outsource materials and services to smaller companies they control or own. This gives them the ability to siphon off profits not reflected in nursing home ledgers. It also gives them some protection against lawsuits.
- Oversight and enforcement: Nursing homes that receive Medicaid and Medicare reimbursements agree to follow minimum care standards. But federal action against these providers is frequently insufficient, and many nursing homes continue to operate without making substantial improvements.
- Aging infrastructure: A majority of traditional nursing homes were built in the 1960s, 70s and 80s and were modeled on hospitals with long hallways and small, shared rooms. The physical environment is awkward and uncomfortable for many residents compared to newer facilities with private rooms more resembling small homes or apartments.
Enforcement and modernization is needed
Advocates for the elderly say better enforcement measures are necessary to hold providers accountable and improve residents’ conditions. The national nonprofit group Justice in Aging says even “good” nursing homes violate federal laws that harm residents.
The group has published a guide titled “25 Common Nursing Home Problems & How to Resolve Them” on common problems encountered by residents and their families. It encourages residents, family members and friends to call out providers that fail to meet the standard of care.