THE GERONTOLOGIST Vol. 49, No. 2 (April 2009)

An article in The Gerontologist (April 2009) examines the results of a first-ever National Nursing Assistant Survey and reports on the prevalence of work-related injuries, use of public assistance, and lack of health insurance among certified nursing assistants.

The lead author of the article, The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce, is Senior Policy Analyst Marie Squillace, Ph.D., of the Office of the Assistant Secretary for Planning and Evaluation within the U.S. Department of Health and Human Services.

The survey results are based on the responses of 3,017 nursing-home based CNAs. To be eligible to participate in the NNAS, a nursing assistant had to be employed by a nursing home (and not as a contract worker); be certified by the state to provide Medicare/Medicaid reimbursable service; be a speaker of English or Spanish; and be employed more than 16 hours per week.

Notable results include:

• More than half were injured on the job at least once during the previous year.
• 16 percent had no health insurance, and nearly half of these cited cost as the reason.
• The median reported hourly wage was $10.04.
• Up to 40 percent had received public assistance (food stamps, rent subsidies, etc.) at some point in their lives, and almost one-third were receiving such aid at the time of the survey.

“The care of 1.5 million elderly and chronically ill persons in the United States is largely in the hands of nursing assistants — the individuals who provide eight out of every ten hours of care residents receive in nursing homes,” Squillace said in a comment about the survey. “Turnover of these direct-care workers is high, which profoundly decreases the quality of life and care of the residents.”

She continued, “These and other forthcoming results will figure prominently in federal and state labor, welfare, and health policy discussions on expanding the pool of workers and on reimbursement policy, regulation policy, and program design. Ultimately, this will lead to improvements in the quality of life and care of older Americans in U.S. nursing homes.”