The COVID-19 crisis is shining a spotlight on problems that have long existed in nursing homes — underfunding has real-life consequences.

Nursing-home workers are always on the front lines of caring for the most vulnerable. Yet due to chronic underfunding of nursing homes at the state and federal level, workers — certified nursing assistants, dietary aides, laundry workers — are stretched to capacity. COVID-19 didn’t create the crisis in nursing homes — it’s shown the reality.

There’s understaffing — I’ve talked to workers who feel that there is extra pressure for them to come in because there is literally no one else to fill in for them. Workers can be forced to work double shifts without notice. Pushing yourself to the point of exhaustion makes it hard to keep up with proper infection-control procedures — made even worse when you have a novel virus.

Being understaffed leads to unsafe client ratios. Workers have to care for too many residents at once, so corners get cut and full precautions aren’t taken. The Life Care facility in Kirkland that has reported many COVID-19 cases had reported staffing levels in the third quarter of 2019 at 1.93 certified nursing assistant (CNA) hours per resident day, well below the state average (2.40 CNA hours per resident day in the same quarter) and below federal best practices, according to payroll data Life Care and all nursing homes are required to submit to the federal government.

And many, many nursing-home workers don’t have access to affordable health care — even when they have a union. Being unable to get health care, while providing health care, is a strange reality.

Nursing-home workers are often loathe to call in sick out of fear of putting their co-workers and residents under even more stress, because there are few workers able to take their place. Recently, I talked to a worker who shared a story about how her already short-staffed nursing home is experiencing a flu outbreak. The nursing-home employer wants any sick worker to stay away until they qualify for the COVID-19 test. So being sick with the flu can mean you’re out of work until those tests become available.

This is a crisis we’ve all had a hand in creating. Most residents in nursing homes are on Medicaid, and the state’s Medicaid rates aren’t keeping up with costs. Nursing homes in Washington are more likely to operate at a loss than any other state in the country. So, the industry can’t recruit and retain the highly trained workforce it needs because a worker gets better pay and benefits from almost anywhere.

Workers are being pushed and stretched to take on more with less. How can we be expected to deliver the best care possible in an emergency state when under normal circumstances our health-care infrastructure is overextended?

Nursing home workers will tell you time and time again, that they do their work because they love the people they care for. They want to provide the best care possible, and they’re trying their best with a woefully unprepared and broken system.

We have to prioritize the needs of our aging population and the needs of the people who care for them, not just in moments of crisis, but every day and every year. That means safe staffing. That means affordable health care. That means living wages. And that means a union. Nursing-home workers tirelessly provide our most vulnerable populations with dignified care. It’s time we give them the dignity they work so hard to provide to others.Sterling Harders is president of SEIU 775, supporting the more than 45,000 long-term care workers providing in-home care, nursing home care and adult day health services throughout Washington and Montana.

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