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By Mary Kay Henry and Ai-jen Poo
SEIU; National Domestic Workers Alliance (NDWA)
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Shelly Hughes is a certified nursing assistant (CNA) at a Washington state nursing home. When she started 15 years ago, she was excited to make a difference by providing the compassionate care she knows residents deserve.
Shelly has long known that short staffing undermines quality care, but the understaffing crisis has recently hit a boiling point. On most shifts, she's one of just two CNAs caring for 60 residents. Residents rely on her for everything from bathing to eating to getting dressed, not to mention daily health emergencies.
Shelly is pulled in so many directions that she must make decisions like whether to leave a resident she's helping bathe alone when she hears another resident calling out for help, knowing there's no one else to respond. She often sobs in her car on her way home knowing residents didn't get the dignified care and attention they deserved that day, despite all her efforts to provide it.
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As leaders of two major organizations that support care workers—the 2 million-member Service Employees International Union (SEIU) and the National Domestic Workers Alliance (NDWA)—we hear stories like Shelly's all the time. Understaffing in nursing homes is a full-blown crisis, and it's getting worse.
There are 1.2 million nursing home residents in the U.S. and growing as 10,000 Americans turn 65 every day. Nursing home workers give their all to ensure safe, quality care for their residents, which is nearly impossible without adequate staffing.
It's time to break the cycle of underestimating and undervaluing the care our loved ones need and those who provide it. Care is the cornerstone of our economy and makes all other work possible. Black and Latina women—who underpin our country's care infrastructure—have been sacrificing themselves to keep our long-term care system afloat for far too long.
Now, we have an opportunity to change that.
In response to workers, advocates, and families who have demanded leaders act on the worsening nursing home crisis, the Centers for Medicare and Medicaid Services (CMS) proposed a rule that includes minimum staffing standards for long-term care facilities. The proposed rule is on the right track toward ensuring public funds fuel quality care and good jobs for CNAs and every worker within a nursing home.
There is no shortage of workers who want a caregiving career, nor is there a decrease in demand for care. Rather, there's a shortage of good, union care jobs that allow people like Shelly to earn the kind of living where she can care for herself and her family. CNAs, who do the bulk of the hands-on caregiving in nursing homes, are paid a median wage of just $14.40 per hour. Nearly 4 in 10 CNAs live 200 percent below the poverty level. Workers frequently hold multiple jobs, sacrificing time with their own families to make ends meet. Physical and emotional burnout force even the most passionate care workers out of the industry in search of higher paying jobs with more support.
If implemented, the CMS rule would require a minimum number of CNAs and registered nurses on each shift, prompting around 75 percent of U.S. facilities to hire more staff. It would also require that caregivers have a voice in decision-making and assessment of staffing needs.
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The rule will reduce risk and improve residents' quality of life, while lifting all of the communities that rely on care, including the communities of color that power our care workforce. And as workers across the country stand up through their unions to demand better jobs, minimum staffing standards will help attract and retain the next generation of care workers and empower them to build careers. Simply put—strong federal staffing standards will save lives and create livelihoods.
The rule's provisions are crucial to our collective future. We need everyone with a stake in the care industry—that's all of us—to raise their voices in advocacy. We cannot continue to blindly entrust taxpayer dollars to employers who would shut down the only option for care in the community, or trade safety of residents and workers for profit.
Although the public comment period ended on Nov. 6, the significance of the contributions made cannot be overstated. The substantial number of individuals who shared their personal experiences of providing or receiving care underscores the necessity for CMS to incorporate these insights. As the agency moves to refine, finalize, and implement the rule, these testimonies remain a critical influence. We'll continue advocating until federal minimum staffing standards are not just a goal, but a reality.
Establishing a strong federal staffing standard is critical to building a country that cares for everyone. Shelly wants every nursing home job to be a good union job where workers have a voice, residents get quality care, and—at a minimum—she doesn't cry in her car on the way home. The rule is an essential first step to making this a reality.
Mary Kay Henry is president of SEIU, an organization that unites 2 million diverse members in the United States, Canada, and Puerto Rico. SEIU members working in the health care industry, public sector, and property services believe in the power of joining together on the job to win higher wages and benefits and to create better communities while fighting for a more just society and an economy that works for all of us, not just corporations and the wealthy.
Ai-jen Poo is the president of the National Domestic Workers Alliance (NDWA), the leading voice for dignity and fairness for millions of domestic workers in the United States. Founded in 2007, NDWA works for respect, recognition, and inclusion in labor protections for domestic workers, the majority of whom are immigrants and women of color. NDWA is powered by over 70 affiliate organizations and local chapters and by a growing membership base of nannies, house cleaners, and care workers in over 20 states.
The views expressed in this article are the writers' own.
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