Kudos to the (Louisville, Kentucky) Courier-Journal newspaper for the following editorial published on Friday, January 25, 2008, that encourages passage of HB 109. The legislation would mandate minimum staffing levels in all nursing homes within the Commonwealth.

Caring for Boomers

The debate in Frankfort over House Bill 109 is just a hint of things to come.

The legislation would attempt to improve the care given by nursing homes, by imposing what really are modest staffing requirements:

One nurse’s aide for every nine residents during the day shift; one aide per 13 residents during the evening shift; one aide for every 19 residents overnight. Also, one nurse for every 21 residents during the day; one per 29 residents during the evening shift; one for every 42 residents overnight.

This would not put Kentucky in the forefront of the effort to make sure nursing homes are properly staffed. Thirty-seven other states already have such rules. HB 109 is overdue.

As activists point out, the state already regulates day-care centers, to make sure enough personnel are on hand to monitor and assist the children who are placed there. There is certainly no less justification for careful oversight of facilities that take care of the elderly.

This is just the leading edge of a movement that can be expected to broaden and gain momentum in coming years. Some baby boomers already have loved ones in nursing homes. Their 1946-1964 cohort has demonstrated, at every stop on its journey through life, an impatience with things as they are, and an inclination to insist that things can be made better. It will insist on good nursing home care for its parents.

After that, many of the baby boomers themselves will take their turn in nursing homes, and the operators of such facilities may be nervous at the thought of ’60s types organizing and demonstrating for better quality, less expensive care.

The better part of valor might be to improve things before Baby Boom agitators show up at the front door with their own luggage.

The usual special interest approach — in this instance, attempting to buy access and influence with more than $110,000 in contributions to lawmakers’ campaigns since 1998 — isn’t likely to work for the industry. Too many Kentuckians have too much at stake, personally, for bad care to go overlooked.

Current state rules have some big holes in them. For instance, they say a “sufficient” number of staff must be on hand, but what’s “sufficient” isn’t defined.

The Kentucky Association of Health Care Facilities (KAHCF), which represents about 250 nursing home and personal care homes, opposes HB 109, and the General Assembly should look carefully into any serious argument that group makes. However, there is no need to take seriously the absurd rhetorical question asked by KAHCF president Ruby Jo Lubarsky: “Why should we allow someone outside the business to dictate to us what numbers are appropriate?”

Nor should any attention be paid to KAHCF vice president Jay Trumbo’s claim that “more bodies walking the hallway doesn’t equate to better care.” It’s true that more staffing will not ensure good outcomes, but hiring too few nurses and nurse aides will ensure the opposite.

Consideration of HB 109 is just a first move in determining how the state can help make certain quality care is provided to coming generations of the elderly. The General Assembly should step off in the right direction.

I’m also pleased to share with you a request from Kentuckians for Nursing Home Reform regarding making the best use of this editorial…

HERE’S WHAT YOU CAN DO NOW….Make a copy of this editorial and mail it with a note from yourself to your state legislators and Gov. Steve Beshear.  Tell them about your bad experiences in nursing homes.  Tell them you want action now.

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