Crisis in Carolinas

“Any society that doesn’t take care of its young or its elderly – it’s a poor reflection on the society.”

–state Rep. Larry Potts, a Republican who co-chairs the N.C. House health committee.

Carolina Crisis

Charlotte Observer’s recent “Left Alone” nursing home series revealed how nursing home operators are intentionally providing substandard care to boost profits. Nursing homes in the Carolinas are dangerously short-staffed.

Hiring and retaining caregivers for poorly managed facilities is a challenge nationwide. The staffing crisis and blanket liability immunity have left vulnerable residents without the care they deserve and need.

The pandemic cases have gone down. Mask mandates and visitor restrictions dropped. However, arbitrary legal immunity for nursing homes still prevail causing deadly consequences for the elderly. As a result, nursing home will abuse and neglect residents without accountability.

Only about one of every five North Carolina nursing homes meet the staffing threshold recommended by CMS and per-reviewed studies.

Experts agree that compliance and best practices requires more staff, more inspections, and more accountability for financial mismanagement.


Luckily, CMS restored training requirements for nurse aides at skilled nursing facilities. The waiver for nurse aide certifications allowed the industry to employ aides for longer than four months without the necessary training and certification requirements.

16 other waivers will lapse in groups. The full list of affected waivers can be found in the CMS memo with reasons and clarifications about conditions for the waivers’ removal.

Providers can also hire help from far beyond our borders, according to McKnight’s. The J-1 visa exchange program was in a LeadingAge blog post to providers.

The number of J-1 visas available this year is twice as high as a normal year. Many of which are foreign nurses ready to work at nursing homes. The industry can get cheap labor from the visa exchange visitor program. The State Department can designate providers as sponsors for individuals on specific career paths. Immigration has long been the backbone of the industry.