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Improve Nursing Home Care

Karen for Caregivers

“Without enough hours for staff, residents are receiving lower quality care. There are times when several patients have their call lights on and due to lack of staff, I must prioritize which resident to tend to first.”

– Karen, Certified Nurse Assistant

California Has Invested Billions in Improving Nursing Home Care…

  • For more than a decade, California has invested heavily in
    nursing home care under AB 1629 in an effort to improve the
    quality of care.
  • In 2015, for a substantially smaller resident population,
    we invested $4.3 billion caring for nursing home residents
    through Medi-Cal.
  • In 2004, we spent $2.8 billion ($3.5 billion in 2015 dollars)
  • Over the course of a decade – even as California cut other
    programs, nursing homes continued to receive the higher AB
    1629 reimbursement rates.

…But Direct Care Staffing Levels Still Fall Short

  • At 3.7 nursing hours per resident day, California on average
    falls far short of the federal recommendation of 4.1 nursing
    hours per resident day (hprd).
  • California’s minimum standard of 3.2 hprd hasn’t been
    re-evaluated since 1999.

Short-Staffing Puts Residents and Workers at Risk

  • Direct care requires time, and when it is rushed, a resident’s quality of life and health suffer. For example, if enough time isn’t spent helping someone eat and drink, then they can suffer malnutrition and dehydration. If skin care is rushed or continence care is delayed, pressure sores can form.
  • Insufficient staffing puts workers at risk, too: many residents require significant assistance with movement, including lifting and turning. Others have mental or psychiatric conditions that can be a risk for a worker who is alone.
  • There is a direct correlation between higher staffing and higher ratings for nursing homes and between lower staffing and more numerous and severe the deficiencies.

People of Color Are More Likely to Be at Risk in Nursing Homes

  • African American-majority facilities were five times more likely to have severe deficiencies than white-majority facilities.
  • Latino-majority facilities were half as likely to have above average staffing as white-majority facilities.

Our Solution: More Hours and a Strong, Transparent Standard

  • At a minimum, California needs to meet the federally recommended standard of 4.1 hours of care per resident per day. Our minimum standard of 3.2 is far below this recommendation.
  • But we need to do more to make this standard real: without clear staffing ratios for direct caregivers, it’s far too easy for nursing homes to manipulate the numbers in order to pass inspection.

We ask that Governor Brown and California leadership keeps its promise to ensure quality care for seniors. This is an opportunity for California to continue to lead the nation by protecting seniors and disabled communities in a time when the White House threatens to slash their care.


Support Increased Staffing Ratios and Quality Care for Nursing Homes

California Must Keep Promise to Care for Seniors
  • During this year’s State of the State address, we heard that CA would do everything it could to “protect the health care of our people.”
  • In our state, over 800 moms, dads, and grandparents are expected to enter a CA nursing home facility every year until the year 2030.
  • We must ensure that CA doesn’t forget about the seniors and people with disabilities who receive life-saving care in these facilities and we will work to improve the quality care standards for our patients of today and tomorrow.
  • Given the risk that the Trumpcare proposal poses on Medicaid funding for nursing home services for seniors, it will be absolutely vital to ensure that California positions itself to protect quality care for seniors.
  • Governor Brown assured thousands of nursing home workers and the seniors they care for that this year the California budget would ensure increasing the minimum standards for safe staffing and quality care.