Guest essay: To fix nursing homes, listen to nursing home workers

California State Senator Henry Stern (D-Los Angeles) has made elder protection a priority in his legislative career. In 2021, he authored SB 650, a key plank in the PROTECT Plan, a series of measures designed to better regulate the nursing home industry. April Verrett is President of SEIU Local 2015, the nation’s largest long-term care union, representing more than 400,000 long-term care providers in both nursing homes and private homes throughout California.


Just over two years ago, Californians were ordered to stay at home to halt the spread of COVID-19. Our lives haven’t been the same since. But one thing hasn’t changed—the conditions that made nursing homes more dangerous than any other place during the pandemic. The global disaster revealed but did not change this fundamental problem: nursing home residents and their safety have taken a back seat to profits.

Nearly 10,000 residents and workers in California nursing homes died from COVID-19 and over 160,000 contracted the virus. This didn’t just happen because vulnerable elderly and disabled residents were concentrated in nursing homes. Profit-driven corporations created work conditions, dangerously low staffing levels, and living environments that functioned as dry brush and hot wind to the COVID-19 wildfire, specifically:

  • Sending staff to work with inadequate or non-existent protective equipment;

  • Low pay that forced nursing home workers to juggle multiple jobs, giving the virus more exposure; and

  • Too few staff members to give patients the care and dignity they deserve, and staff so exhausted and emotionally spent they are leaving the industry in droves.

Meanwhile, nursing home owners found even new ways to profit from the pandemic. Hundreds sought state regulators’ permission to operate short of newly established legal staffing guidelines. The most ruthless actually kicked residents out to make room for clients who would bring in more government money. Billions in state and federal bailouts went into executives’ pockets rather than stabilizing a dwindling workforce. Hailed as “essential” and “heroes,” nursing home workers have been treated as anything but. Workers are fed up with low pay, unsustainable workloads, and little to no respect from corporate bosses. 16,000 have already left the industry since 2020, and in a recent poll, fifty percent of those who remain say they are likely to leave in the coming year. That’s why nursing home workers are coming together to demand a real transformation of this broken industry. Last year, we worked together on legislation, SB 650, to shine a light on the corporate shell games that nursing homes have played in order to hide their profits and evade accountability. But we need to do more. And listening to caregivers is the key to change at all levels. Adequate compensation so that nursing homes can attract and retain caregivers is only the starting point. Exploiting immigrant workers and low-wage women of color while keeping facilities dangerously short staffed have been two primary money-making strategies. This represents a continuation of the long, racist and sexist history of devaluing the profession of caregiving. Staffing standards must also be enforced so that caregivers can do the job they love and that inspires them: providing thoughtful, respectful, attentive care to those in need. President Biden recently outlined steps by his Administration to hold nursing homes accountable for safe care. The way public systems like Medi-Cal pay for nursing care must also be reformed so that adequate staffing and quality care are incentivized throughout the industry. But most importantly, caregivers need to have a voice in the conditions that affect care. That’s why we have proposed, through the California state budget process, the creation of a Skilled Nursing Facility Quality Standards Board to take charge of this troubled and deadly industry. The Board would bring together regulators, workers, advocates, and nursing home owners to collaborate in setting a new course. It would have the power to set wages, staffing standards, and benefits. It would also be charged with looking into issues of turnover, training, retention, and racial equity in the industry. The devastation nursing home workers faced wasn’t inevitable. It was preventable. When caregivers are respected and listened to, they will ensure it never happens again. Learn more about our Put Care First agenda at www.putcarefirstcalifornia.com.


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