Hazard Pay for Managers?

Underappreciated

The Wall Street Journal reported that senior managers in some New Jersey VA nursing homes received Covid-19-related hazard pay despite earning too much to qualify. Obviously, the federal funds were for lower-level state employees who worked in dangerous conditions taking care of Covid-19 residents. The payroll records show caregivers got far less than these administrators from the hazard-pay program. Agency emails show that nursing-home managers took the payments after being repeatedly told that they were ineligible.

Michael Barnett is a Harvard assistant professor of Health Policy and Management who studies staffing and turnover in the industry. He warns:

“What you’re telling nursing home assistants, nursing home staff, is that they need to work for probably the same amount of pay — or maybe a small raise, who knows — and they need to put their lives and their family’s lives at risk by going into a nursing home where Covid-19 could creep in at any time.”

Some sociologists and economists call the current labor challenge ‘The Great Resignation.’

Under Staffed

Medicare waste, fraud, and abuse is widespread in the industry, not just veteran nursing homes. For-profit nursing homes also abused the bailout funds. Covid-19 ravaged nursing homes across the United States highlighting the fatal consequences of unsafe staffing. Systemic shortages in long-term care facilities cause pain, injury, and death.

“Seventy-five percent of the nursing homes had inadequate staffing before the pandemic started,” said Charlene Harrington, a staffing expert and professor emerita at the University of California, San Francisco. “It’s not surprising that they weren’t able to cope with it.”

Federal regulations require that facilities have “sufficient nursing staff” with the necessary skill sets to keep residents safe and maintain their well-being. We need to enforce this standard for the safety and well-being of the residents. The minimum safe level of 4.1 hours per patient day for caregivers is a good start.

A 2001 CMS study found staff should spend at least 4.1 hours per resident daily. The report confirmed that neglect was directly associated with patients’ adverse events. The negative outcomes include pressure injuries, medication errors, new infections, and falls.  Facilities with higher nurse staffing levels have reduced emergency room use and rehospitalizations.

A 2016 report co-authored by Harrington said the “profit incentive has been shown to be directly related to low staffing.” For-profit facilities operate with less staff and more quality deficiencies than their non-profit counterparts.