REGULATE:
Elder abuse is inexcusable, and those who break the public's trust should be
punished to the fullest extent of the law.
The organization I represent, the Missouri Association of Homes for the
Aging, represents not-for-profit providers of senior services for all levels of
care. We supported the Missouri Protection of the Elderly Bill (SB670). Had
this bill passed, it would have given the state additional tools to address
those few providers who provide poor care.
In condemning abuse, let us also acknowledge the many thousands of frontline
caregivers who provide exemplary, compassionate care for our frail nursing home
residents. These dedicated nursing home caregivers continue in this noble
profession while a few abuse the system and give all nursing homes a black eye.
Not-for-profit long-term care providers have been setting the standard for
years, even in the face of inadequate reimbursement and an extremely difficult
labor market.
Today, all over the country, nursing facilities, both not-for-profit and
for-profit, and the health care profession are experiencing a staffing crisis.
Three key factors in this workforce crisis are the inability of most nursing
homes to compete with the wage and benefit structures offered by other
employers, insufficient numbers of qualified nurses and the public perception
of nursing homes.
Medicaid is the single largest public source of funding for long-term care
and nursing homes. For years, Missouri has admitted that the state is
underfunding nursing homes to the tune of more than $13 a resident per day for
care. For an average nursing home of 120 residents, that means $569,400 a year.
The average Missouri nursing home Medicaid payment is $95 a day. Of the $95,
the state pays $14.33. The remainder comes from the federal government, the
resident's Social Security and a tax paid by nursing homes. This $95 must pay
for all required nursing care, staff benefits, medical supplies, activities,
therapies, food, room, laundry, building maintenance and equipment, staff
training, utilities, insurance premiums and other administrative expenses. The
private-pay residents are left to pick up the shortage the state and federal
governments refuse to pay.
Inadequate payment contributes to staffing problems, but the staffing crisis
is not simply one of supply.
The more fundamental, long-term dilemma is how to develop a committed,
stable pool of frontline workers who are willing, able and prepared to provide
quality care to people with long-term care needs. Our association has suggested
legislation to support the education of nursing assistants, welfare-to-work
grants, training for supplemental staff in nursing homes and programs that
boost staff recruitment and retention.
We also continue to ask the state to change the regulatory enforcement
system to focus less on paperwork and more on the outcomes of resident care,
with the goal of raising the quality of care in Missouri. Regulations should
protect the public interest, not prevent caregivers from providing services
because it takes longer to document it than to do it.
Missouri officials must make the commitment to ensure that quality of care
is provided to all nursing home residents. Nursing home providers continue to
stand ready to help, for it is only together that we can truly improve quality
of life for vulnerable seniors.
A FORUM FOR OTHER VOICES, IDEAS AND OPINIONS\
Denise Clemonds is executive director of the Missouri Association of Homes
for the Aging, Jefferson City.
