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REPORT: Poor Quality Nursing Home Jobs Undermine Care Quality

April 12, 2016

Poor quality nursing home jobs are leading to high turnover and staff vacancies, preventing residents from receiving the high-quality care they deserve, a new PHI report argues.

Raise the Floor: Quality Nursing Home Care Depends on Quality Jobs outlines the case for improving jobs for the 650,000 nursing assistants employed by the nation’s 15,000-plus nursing homes.

These workers — who are 91 percent female, 35 percent African American, and 20 percent foreign-born — provide the majority of hands-on assistance that allows nursing home residents to live with dignity and as much independence as possible.

But nursing assistant jobs are characterized by poverty-level wages and poor benefits; erratic, often part-time schedules; limited support from supervisors; and little chance to advance beyond the entry level. Yearly wages average $19,000, barely enough for a family to meet their most basic needs.

In addition, PHI’s research team estimates that more than 75 percent of nursing homes fail to meet the federal recommended staffing level for nursing assistants. This understaffing means that nursing assistants are constantly under stress and have time only to meet the residents’ most basic personal care needs. This leads to dissatisfaction and burnout among staff and inadequate support for residents.

In the report, Maribel Rodriquez, a nursing assistant from Waterbury, Connecticut, describes her job as “hard physically, mentally and emotionally.” The work takes a toll: nursing assistants are injured on the job three and half times as often as the average American worker.

“We’re overworked, underpaid, and unappreciated,” Kim White, a nursing assistant in Florida, told Bryce Covert of ThinkProgress in an April 12 article.

The poor quality of jobs like Rodriquez’s and White’s has left the nursing assistant workforce profoundly unstable. Average yearly turnover rates top 50 percent and are growing as the economy rebounds.

This instability negatively affects nursing home residents. “Unstable staffing undermines quality of care in nursing homes,” the report says. “The best care is delivered by a consistent team of experienced caregivers who know their residents well.”

“Increasingly, employers report that they cannot recruit sufficient numbers of qualified workers,” PHI President Jodi M. Sturgeon said. “Nursing homes deliver an indispensable service, providing support to individuals who cannot live safely in their homes. Ensuring quality jobs for nursing assistants is essential to improving the quality of care in these long-term care settings.”

Raise the Floor makes the case for providing nursing assistants with the resources they need to succeed at their jobs, including public investments to increase wages, improvements in training and career opportunities, and innovations in leadership and supervision.

Quality jobs are essential to building a stable, skilled workforce prepared to provide care for today’s nursing home residents — and the growing numbers of elders who will need care and support in the coming decades.

Raise the Floor was produced by PHI with support from the W.K. Kellogg Foundation.

— by Matthew Ozga

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