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The Biden administration has taken steps to increase the staffing levels at nursing homes. Earlier this spring, it introduced a national minimum staffing requirement. Employee turnover at nursing homes skyrocketed during the pandemic, when more than 200,000 residents and staff died. The government says more staff translates to better care, but the mandates are not pleasing everyone. Ashley Milne-Tyte has this report.
ASHLEY MILNE-TYTE, BYLINE: Registered nurse Vida Antwi has spent 20 years working at Gurwin Jewish Nursing and Rehabilitation Center. It's a nonprofit nursing home on Long Island with art photography on the walls, plenty of natural light and a few hundred full-time residents.
VIDA ANTWI: You've been living here for more than five years. You know that?
UNIDENTIFIED PERSON: How much?
ANTWI: Five years.
MILNE-TYTE: Antwi is chatting with a resident. We're not using her name due to her medical condition. She says she's happy here most of the time.
UNIDENTIFIED PERSON: But it's hard when your son isn't around too happily.
ANTWI: Yeah. But you - I tell you - I always tell you, you got family here. We're all your family. Don't I tell you that?
MILNE-TYTE: Antwi credits her employer with making a big effort to hire and train new nurses and nursing assistants coming out of COVID. But...
ANTWI: Even though we try to get people on board, some people come in, and they just leave. But...
MILNE-TYTE: That's a problem because the new government staffing rule calls for more nursing staff and more hours of care than many facilities currently offer. Antwi's boss, Stu Almer, CEO of Gurwin Healthcare System, says he'd love to have all the nurses he needs. But given the country's nursing shortage, how is he meant to find them?
STU ALMER: There just aren't enough staff. So it makes us curious as to why standards like this go into effect. And we're all working very hard, competing for the same quality staff to run a good facility.
MILNE-TYTE: Another problem, he says - hiring people, training them and increasing benefits to keep them, as his organization is doing - it's expensive. He says the government is insisting on more staff but isn't offering any funding to pay for them.
ALMER: We can do so much more if we had the economic support that we need.
MILNE-TYTE: Almer says his nursing home doesn't want to take on more patients than it can adequately care for, so it's not operating at capacity right now.
Lori Smetanka is executive director of the National Consumer Voice for Quality Long-Term Care. She says, if anything, the new mandates on staffing and levels of care don't go far enough.
LORI SMETANKA: This new rule sets a floor or a baseline below which you cannot go, yet that is not to say that you shouldn't be higher.
MILNE-TYTE: But she says it's a good first step, since many nursing homes have far too few employees to meet needs. Matt Perrin has seen this firsthand. He lost his mom two years ago. She had dementia and spent the last six months of her life in several nursing homes in Massachusetts. He says staff were kind and doing their best.
MATT PERRIN: But they were set up to fail, in my opinion. That fact is really close to the wound that's healing in my heart based on how the end of my mom's life went - how the last six months went.
MILNE-TYTE: He says the staff had too little training in dementia care. This led to problems as his mother struggled to find her way around and communicate. At her final place, he says there was a handful of employees per shift for around 50 residents.
PERRIN: Like, they just didn't have the time to really lean into each of the people under their care as people.
MILNE-TYTE: But it's not just staffing. He believes more changes are needed in long-term care to ensure people like his mother can live and die with dignity.
For NPR News, I'm Ashley Milne-Tyte.
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