BUFFALO, N.Y.
For-profit nursing care in crisis
By Bev Hiestand
Buffalo, N.Y.
Those in Western New York who need the care only a nursing
home can provide are facing a profound crisis.
The Dec. 11 Buffalo News published results of a yearlong
investigation of 93 nursing homes in Western New York. The
newspaper based its findings on three years of New York State
inspection reports and hundreds of interviews with employees,
administrators, residents and their families.
The article concluded, "The worst staffing crisis in decades
at nursing homes nationwide--including this region's 93
facilities--threatens the quality of care to elderly residents
just as the aged become the fastest-growing part of the
population."
The investigation revealed that despite good care provided
by many dedicated workers who express deep concern for
residents, "too many of our loved ones are trapped in
understaffed facilities where call bells go unanswered and they
lie for hours in their own urine and feces. Or where the food
is cold and activities are so lacking that many residents spend
long hours every day propped in wheelchairs in front of a
television set."
The News noted that staffing levels for aides at nearly 98
percent of the homes fall below the standard recently set by a
federal study as "optimum." The constant pressure for workers
to rush due to understaffing can lead to mistakes.
Nursing home residents are old and frail, making staffing
shortages more dangerous. Patients are being pushed out of
acute-care hospitals at an ever-faster pace. As a result they
arrive at nursing homes with surgical wounds, intravenous lines
and other conditions that require continual attention.
In all nursing homes, nurses' aides provide the greatest
share of care. In some homes, each aide must attend to 30 or
more patients on each shift. That means feeding, washing and
assisting patients to the bathroom.
"Some nights, we'd have four aides trying to take care of
more than 300 people," said Russell Reynolds, a former nursing
aide at a for-profit nursing home in suburban East Aurora. "You
might have to spend a half-hour helping somebody get to the
bathroom. In that time, two other residents might fall down and
need help." (Buffalo News, Dec 10)
Most nurses' aides report that the workload is unbelievable
and demoralizing, with no time to spend even five minutes
talking to a lonely resident.
The workforce of aides in this region is made up
predominantly of women--many single with children. They are
largely African American. They are often forced to work double
shifts. And the job is difficult, stressful and emotional.
The Dec. 11 News noted that "Fewer people are willing to do
this work for the low pay, starting around $8.50 an hour with
little chance of advancement to better-paying, less stressful
jobs."
The crisis of understaffing is dangerous for workers, too.
Back injuries are common from lifting residents. Aides are
exposed to infections. Federal labor statistics reveal that
nursing home workers rank fourth in the country in frequency of
injuries and illness--a rate higher than firefighters.
Aides stress the lack of adequate education about how to
care for confused and aggressive residents. The News pointed
out "a manicurist studies longer to get a license to do
nails-250 hours-compared to the 100 hours of training it takes
to be an aide."
Is it any wonder that the turnover rate in some of these
homes is 100 percent? (Buffalo News, Dec. 11)
Who profits? Who pays?
The Dec. 12 Buffalo News emphasized, "If solutions aren't
found, some experts believe the nation is headed for a two-tier
system based entirely on money. Wealthy people would live in
relatively comfortable facilities with good food and decent
medical care. Poor and middle-class people would essentially be
warehoused in hospital-type facilities that would be even more
understaffed than they are today."
Most people can't afford private pay rates that average
$64,000 to $70,000 a year, far more expensive than a Harvard
University education. Medicaid, the state-federal health
program for the poor, doesn't cover the cost of basic services
and only pays after potential residents exhaust their
savings.
Medicare cuts have worsened the situation, especially for
not-for-profit homes.
The workers certainly aren't getting wealthy from the high
cost of care. The for-profit industry has funneled millions of
dollars into anti-union campaigns to keep workers' wages and
benefits low. As a result many nursing-home employees are not
organized into unions. And that makes it harder to struggle
against poor working conditions.
So who is getting rich? The owners of for-profit nursing
homes.
Financial data for 550 nursing homes in New York State
showed profits and surpluses totaling $354 million in 1999.
Much of the profit comes from taxpayers in the form of Medicaid
and Medicare reimbursements.
The Dec. 10 News reported that from 1997 to 1999, the three
most profitable nursing homes in the region raked in nearly
$17.6 million in profits. But not unexpectedly, these homes
ranked near the bottom when evaluated for quality of care.
Neil M. Chur Sr. runs nine local nursing homes that are very
lucrative. Three of his facilities are rated among the region's
15 worst. Many have been cited for incidents of poor care
including understaffing, poor nutrition, patient care and
medication practices, and for filing false documentation on
patient care.
Inspectors found maggots in a facial wound of a cancer
patient at one of his facilities. At another a resident choked
to death on her breakfast while she was left eating alone.
The News reports that Chur has made a fortune, turning him
into a polo-playing multimillionaire with estates in East
Aurora, N.Y., and Naples, Fla. Chur's 209-acre East Aurora
estate includes a mansion, a guest house, a polo field, a small
golf course and climate-controlled stables for his Arabian show
horses. He travels between his properties on his company's
Learjet.
What will it take to provide quality health care? Servile
and cowardly politicians in both parties revealed their
priorities when they voted for a War Powers Act that gave Bush
and the generals carte blanche spending powers for war against
the Afghan people. That unlimited spending for warfare is
draining the coffers of much-needed funds for health care,
education and other necessities.
Together, unions and communities can turn the priorities of
funding back to where they belong: meeting peoples' needs. But
it will take a grassroots struggle to win these resources for
better care for the sick and elderly, and for better wages,
benefits and working conditions for healthcare workers.
Hiestand is a nurse and healthcare union activist in
Buffalo.
Reprinted from the Dec. 27, 2001, issue of
Workers World newspaper
This article is copyright under a Creative
Commons License.
Workers World, 55 W. 17 St., NY, NY 10011
Email: ww@workers.org
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