Nursing home pay must be addressed

Nursing homes in Iowa and across the country are understaffed, leaving neglected residents unable to get the care they need. That’s unacceptable when the lives of vulnerable people are hanging in the balance.

For Iowans with loved ones in nursing facilities, for the residents themselves, this is a constant worry. And it’s a failure of state leaders who have done too little to solve the staffing problem.

Instead, they lobbied against federal staffing rules that would have required more hours for care from registered nurses, among other changes.

Clark Kaufman, with the Iowa Capitol Dispatch, reported this week that an overwhelming majority of nursing homes in Iowa and across the nation are operating with fewer staff members than the recommended number.

Among Iowa’s 410 nursing homes, Kaufman reported, eight are staffed 40% or more below what residents need. That’s down from 11 last year, although four facilities are just under 40% of recommended staffing. Many facilities across the country rely on nursing aides while coming up well short for staffing needs for registered nurses.

“The significant staffing shortfall is more than just a statistic,” Richard Mollot, LTCCC’s executive director, told Kaufman, “it reflects the daily reality of thousands of vulnerable residents enduring avoidable pain and neglect simply because too many nursing homes are not being held accountable for meeting even basic care standards.”

Iowa ranks in the middle among states, with an average staffing level 20% below needs. But that’s hardly an excuse to reject the need for major changes.

Pay is a major problem driving both staffing shortfalls and high turnover.

In 2022, according to an analysis by Iowa Caregivers, the median hourly wage for a nursing assistant was $14.42. Entry-level wages are just more than $13.00. Many workers rely on child care assistance, Supplemental Nutrition Assistance Program (SNAP), and the Children’s Health Insurance Program (HAWK-I).

Not surprisingly, the turnover rate for CNAs was 74% in 2022, according to the analysis.

A seasonal mower at Cedar Rapids parks would start at $15 per hour and a cashier at major area gas stations would start at a rate of $16 per hour, including higher shift differentials.

A nursing home should be a place of safety and dignity. That idea is undermined when people doing the hardest work earn low wages.

And this is a situation that’s likely going to get worse. President Donald Trump’s budget proposal includes a $700 billion cut in Medicaid funding over 10 years. Medicaid payments are a crucial source of funding that determines pay levels.

The U.S. Department of Health and Human Services is seeking to delay new staffing rules until 2035. It’s a major victory for the nursing home industry, which has plenty of clout in Washington, D.C. and Des Moines.

This leaves the state of Iowa to do the right thing and address low pay and benefits. Targeted wage enhancements from the state — similar to what's being done with childcare workers is one. Democrats proposed a list of 14 bills this past legislative session to address lax oversight and other issues. Republicans, who run the Legislature, scrapped them all. This issue is important enough to put the partisan games on hold and find bipartisan solutions.

(319) 398-8262; editorial@thegazette.com