An investigation has found that around 6,000 patients in nursing homes in Illinois are being hospitalized every year after contracting sepsis. About one-fifth die as a result of their infections. The cause? Low staffing levels in nursing homes, which fall far below federal recommendations, may play a significant role.
Now, state Sen. Jacqueline Collins (D-Chicago) has introduced legislation which aims to hand out tougher penalties to nursing homes without enough staff on hand. “You would think that anytime you put your loved one in a nursing home, the care would be there because it’s supposed to be regulated,” said Collins. “But we find that’s not the case.”
Sepsis is an infection of the blood that may occur in individuals who are bedridden and who have a variety of conditions, including pressure sores, urinary tract infections, or pneumonia. The infection is most commonly bacterial, but can also be protozoan, fungal, or viral. Whatever the root cause, the condition is often life-threatening.
Many infections can be prevented simply via proper hygiene. Patient advocates and regulators argue that low staffing levels can lead to an increase in cases since there is not enough monitoring of the infections and bedsores which can precede the disease.
The Illinois AARP is supporting Collins’ bill after an investigation was published last year by the Chicago Tribune and Kaiser Health News. The investigation showed that over three-quarters of nursing homes in the Chicago area were staffed below the national average. While there are no federal regulations stipulating how much nursing time there should be per resident, a 2001 federal study suggested 4.1 hours per patient every day. Illinois state law, however, only requires 2.5 hours of daily care per resident. Despite this, the investigation found that a quarter of Chicago-area nursing homes were not even staffing to this level.
Certified nursing assistant Shantonia Jackson has experienced these conditions first hand. “I’m not giving them proper care that I need to give,” she said, explaining she has completed shifts where she had to look after 15 residents with Alzheimer’s disease simultaneously.
Collins’ legislation would not increase the required number of hours of care. Instead, it would require state regulators to check staff numbers by comparing data from each nursing home with payroll data submitted to Medicaid every quarter. If regulators discover a nursing home has been understaffed, they would then fine the home.
The fine would come to at least double the amount the nursing home saved by not staffing correctly for that quarter. For example, imagine a nursing home needed to spend $1 million in payroll in a quarter to ensure patients received 2.5 hours of care every day, but the nursing home only spent $800,000 on payroll (and as a result did not provide enough coverage). In this situation, the nursing home would have saved $200,000 by understaffing. The fine would, therefore, be $400,000 or higher. Additionally, signs would be posted on all doorways saying the home had failed to meet legally required staffing levels for the previous quarter.
The new bill would also require the consent of residents or their families to administer psychotropic medication. Without adequate staffing, explains Jackson, nursing homes frequently use these medications to sedate residents so they do not have to give them proper care.
The Illinois Health Care Association acknowledges that the low levels of staffing at the 500 nursing homes it represents. However, the association lays the blame on the state’s low Medicaid payment rates which, it says, form the bulk of each nursing home’s revenue.
