Our team of attorneys working on nursing home neglect matters frequently point to staffing levels as a key factor in the prevalence of widespread mistreatment at long-term care facilities. The logic is pretty straightforward. Nurses and aides perform the bulk of basic caregiving and routine medical functions at these facilities. Each individual worker can only do so much each day in the work time they are allotted. Therefore, there must be a sufficient number of employees to ensure that each individual resident or patient receives the care they need.
Unfortunately, this runs counter to the goal of many owners and operators who have to pay those employees. They seek to lower costs in order to increase profits to owners and shareholders. By cutting back staffing levels to the bone, their payroll significantly decreases and they make more money. But facility residents suffer as a result.
This dynamic is often discussed in the nursing home context. It is important to note that the same issues apply in other medical facilities–like hospitals. When a hospital does not have sufficient nursing levels, patients may unsuspectingly placed in danger.
Mandatory Minimum Laws
Noting the critical importance of proper levels, many advocates have fought for laws to ensure facilities are obligated to meet certain basic staffing level requirements. That is exactly what happened in nursing home neglect prevention laws. Illinois law mandates a certain number of hours per day of individual nursing care per resident (though there is widespread abuse of this law).
Considering the similar dynamic, doesn’t it make sense to have the same basic safety rules in place for hospitals? That is exactly what many advocates are pushing, but it is a long political slog on a state by state basis to get these rules in place. That is because medical associations are a powerful lobbying entity who fight tooth and nail to prevent any safety requirements such as this.
A Kaiser Health News article last month explored the issue. The story noted how only one state–California–currently has a law on the books which mandates a minimum nursing level in hospitals. Similar laws have been proposed in many other states, but they have all been struck down. The main arguments comes from hospital administrators who claim that the rules take away staffing decisions from individual administrators while coming with far too high of a financial burden. Making claims about rising healthcare costs is always a surefire way to cause panic.
However, nursing organizations stand in direct opposition to those administrators. They note that patient lives are risked far too much, because there is only so much that an overworked and outnumbered nursing staff can do.
Those concerns are backed up by science. For example, a 2004 survey form the U.S. Agency for Healthcare Research and Quality found that lower “nurse-to patient” ratios correlated with more adverse medical outcomes. In other words, patients fared worse in facilities with fewer nurses.
Hopefully the momentum continues and Illinois hospitals begin to better understand the need to prioritize patients over profits at all times–including on issues like nursing staff levels.
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