• John & Terri Hale

The COVID crisis in Iowa’s nursing homes – have we reached the desperation point?

As published in the Cedar Rapids Gazette

Governor Reynolds’ November 19th press conference focused on the growing incidence of COVID in Iowa’s nursing homes and the workforce shortages that exist there. Many questions have been asked as a result. Here are some of them, and our comments.

Q. Much of the concern about the growth of COVID relates to the workforce available to care for nursing home residents. Are staffing levels adequate?

A. Nursing home industry spokespeople say that staffing levels have been and are adequate. We strongly disagree. Staffing levels were inadequate and unacceptable prior to the pandemic, and they are even worse now.

Q. The Governor’s guidance on workforce shortages assumes that there are "extra" staff members who just need to be identified and loaned to struggling facilities. Is this true?

A. No. There is no pool of extra workers. Hospitals, nursing homes, assisted living centers and home care agencies are all understaffed.

Governors and legislators have known about the workforce crisis in long-term care settings for years but have done little more than talk about it.

Elected officials who set legislative priorities have regarded these workforce issues as insignificant and not worthy of their time. The chickens have now come home to roost. Their inaction has produced disastrous consequences.

We need to deal with this crisis, now. Elected leaders like to describe front-line staff members as “heroes” but they do nothing to ensure they are treated and compensated as such. It’s well past time to have nice words backed up with meaningful action.

Q. The Governor’s guidance on workers says that the use of temporary help from staffing agencies should be part of the solution. What are the ramifications?

A. Potentially not good. Studies have shown that temporary employees, who travel from facility to facility, can carry the virus with them, spread it from one facility to another, and make a bad situation worse.

Q. The Governor’s new guidance also says that infected staff can be used to care for non-infected residents as a last resort. Is that wise?

A. The idea raises all kinds of red flags. The situation in nursing homes has gone from bad to desperate when government says it’s OK for infected staff members to care for uninfected residents. While desperate times may call for desperate measures, there are better approaches. Iowa should consider doing what other states have done – use the National Guard to support existing staff members. If this is a war, let’s fight it like one.

Q. The Governor is routing an additional $14 million in taxpayer dollars to Iowa nursing homes to help with the COVID crisis. What kind of rules and transparency should govern the flow of those dollars?

A. There should be specific parameters for use of the additional dollars and transparency on where they flow and how they are used. We believe dollars should be used to give wage increases to existing staff, and to raise the wage floor for all newly hired staff.

Q. What are your thoughts overall?

A. Sadly, the Governor’s latest statements and actions simply document how feeble, tardy and inadequate the government’s response has been in recognizing and dealing with the COVID and workforce crises in long-term care settings – resulting in more sickness, suffering and death.

This inadequate response has not been due to a lack of awareness. For nine months, journalists have been documenting what was unfolding and advocates have been pleading for action. The only voices state government has seriously listened to are those of the trade associations which represent the interests of owners and operators of nursing homes.

Nursing home residents, families, front-line workers and those who advocate for them have not been given a seat at the table. Their perspectives needs and ideas have not been deemed as important. That’s been a short-sighted and losing approach.

This crisis is far from over. The voices absent from the conversations to-date should now be heard.

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