By Kay Kaylor
I advocate for residents in skilled nursing and assisted living residences as the Region 9 long-term care ombudsman employed at the San Juan Basin Area Agency on Aging (SJBAAA). Some of the many aging and care concerns will be addressed here.
Two proposed government acts at the national level are geared toward improving the quality of care for residents in nursing homes. Six U.S. senators, including Michael Bennet from Colorado, introduced on Aug. 10 the Nursing Home Improvement and Accountability Act of 2021, and the National Consumer Voice, along with congressional advocates, is promoting passage of H.R. 3733, the Essential Caregivers Act.
Among other items, the Senate proposal would allocate funds for studies every five years to determine minimum nursing home staffing levels and ratios. Long opposed by the long-term care industry, past staffing ratios, such as a specific number of nursing staff per resident, have never been implemented. Advocates have argued that ratios are necessary to meet the care needs of residents.
This improvement act would provide Medicaid funding for long-term care providers to support additional registered nurses (RNs) so that they are available 24 hours daily and infection preventionists with services available at least 40 hours a week. It also allows a Demonstration Program with funds to modify some buildings to promote person-centered care. Participating facilities for the program must have five to 14 residents, use private rooms, maintain accessible outdoor space for residents, and have resident and family councils that meet regularly.
The House of Representatives’ proposed Caregivers Act would give residents of nursing homes the right to access essential caregivers during any public health emergency, such as infection outbreaks. The resident could select up to two caregivers who would provide support and companionship even if the facility is closed to visitation. For guaranteed visits and to avoid risks to residents and staff, the essential caregiver must follow infection and safety protocols. During the current pandemic, visitation has been prohibited or restricted, including giving visitors time limits and requiring appointments.
By law, nursing home residents have the right to unrestricted visitation. Even during this pandemic, “compassionate care” visits have been legally required, but in practice such visits often occur only if a resident is declining quickly. Especially during national staffing shortages, these essential caregivers, usually family members or friends, provide emotional support, oversight and hands-on attention to a resident’s needs. The act would guarantee daily visits for enough time to benefit the resident.
Advocates, families and inspectors have reported that during this pandemic, some long-term care residents, and even Medicare-funded rehabilitation residents, experience extreme weight loss and decline in mobility and other abilities, lack dental care and bathing, endure dehydration, and suffer from depression and new medical conditions, such as pressure ulcers.
SJBAAA offers resources for people age 60 and older or with Medicare; see sjbaaa.org. For further information and assistance, call (970) 264-0501 and listen to the recording to select an extension.