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Sunday, March 6, 2022

Governor McKee’s executive order leads to suffering and death in nursing homes

“If Governor McKee doesn’t change course and allow the safe staffing law to proceed, the quality of care will continue to get worse and residents will suffer.” 

By Cheryl Chianese, RN in UpRiseRI

Recently, Governor Daniel McKee issued an executive order delaying The Nursing Home Staffing and Quality Care Act. There couldn’t be worse timing to halt implementation of the nation’s strongest staffing law and it’s imperative he change course. 

I offer this perspective both as a former nursing home employee and also as a daughter who watched my father suffer firsthand from inadequate nursing home staffing.

In the 1990s, I was employed as a staff RN/shift supervisor at what was then Elmhurst Extended Care, now known as Elmhurst Rehabilitation.The dignity and comfort of our residents was priority. This was reflected in the quality of our food, medical supplies and linens.

It was also reflected in our staffing; 30 nursing home residents could depend on 5-6 CNAs and two nurses. Registered nurses always filled supervisory positions. Standards of care have drastically changed, much to the heartbreak of so many families.

My father was first admitted to Elmhurst on November 3, 2019 for temporary rehab after a hospital stay. But problems with his care became quickly apparent and his condition rapidly deteriorated – despite the dedication of his caregivers.

The first night he was admitted, my father locked himself in the bathroom, which was related to his increased confusion. Due to lack of staffing, it went unnoticed for hours. I then learned that he was sleeping nightly in a chair near the nurses’ station which was a “resolution“ to that event and decreased staffing. On several occasions, I observed him wearing ripped socks and johnnies. I would bring in Gatorade, Ensure and snacks each visit because of lack of supplies. On one occasion, I noticed he had flu symptoms. I asked the staff to take his vitals but there was not a working thermometer on the unit.

Once the pandemic hit, all in-person contact ceased. I was reduced to monitoring him through staff phone calls. As I could no longer bring in supplements and encourage eating and hydration, he became deconditioned and lost 13 pounds in less than 2 months. Then, I was contacted that he had COVID and was being moved to the COVID unit. Because of short staffing, nurses were forced to float to all units, including the dementia and covid units, which could have led to cross contamination of the virus.

On June 4, 2020, my dad passed away from COVID-19. I did not have an opportunity to say goodbye.

Throughout his time there, I got to know my father’s caregivers. I was aware of their frustration and despair. Many of them came from other countries, made minimum wage and were not given proper support and resources. It was common for only 3 CNAs and one LPN to be responsible for 29 residents. Sometimes one nurse had to cover two units.

It is devastating to think that my father’s experience is commonplace in today’s long term care system. Quality care has been compromised for profits at the expense of patients.

In conclusion, If Governor McKee doesn’t change course and allow the safe staffing law to proceed, the quality of care will continue to get worse and residents will suffer. There will always be a need for skilled care for people like my dad who could no longer safely stay at home. 

But if competitive wages and safe staffing levels are not offered, nursing homes will lose valuable employees. The future of our long term care system is determined by the decisions our leaders make today. It’s time Governor McKee makes the right choice.

For more on the Nursing Home Staffing and Quality Care Act, see:

After long battle, Nursing Home Staffing and Quality Care Act becomes law

Report: Inadequate staffing levels and low caregiver wages magnified nursing home crisis