Improve Staffing

Facilities Increase Staffing

Politico published a great article from elder advocate and health care expert David Grabowski. He studies long-term care and the economics of aging. Grabowski is a professor of health care policy at Harvard Medical School.

“I’ve been studying long-term care settings for many years, and I think there’s a quicker and possibly even more effective approach we can take in the short term to ensure better care for our seniors: improve staffing.”

The only way to improve staffing is requiring safe levels with competent qualified caregivers paid a living wage. Facilities pay staff poorly. Certified nurse aides often get minimum wage. The nursing home industry pays licensed nursing staff less compared to hospital colleagues.

Meanwhile, caregivers at nursing homes died twice as much as hospital colleagues during COVID. That leads to even higher turnover which negatively affects the quality of care.

Facilities around the country have dangerously low levels of staffing. The average U.S. nursing home has an annual staff turnover rate of 128 percent.


Increase minimum staffing levels. The federal standards are low and have not been updated in over 30 years.

Increase staff pay and benefits. Raise nursing home staff pay. Many certified nurse aides would see their hourly wages increase under the $15 minimum wage proposed by the Biden administration.

Raise Medicaid reimbursement. Resident advocates have questioned whether a sufficient amount of existing public nursing home funds are spent on staffing.

Increase financial transparency. We lack transparency in how nursing homes spend public dollars on staffing and other areas. The regulators need to be able to follow the public’s money and ensure it is being spent on staffing as policymakers intended.

Americans can do this. We can improve the care at long-term care facilities. Americans are the most optimistic they’ve been about the nation’s direction in nearly 15 years, according to the polls.  One reason is that more than 60% of U.S. adults have at least one dose of the vaccine.