>> Reporting from the state capitol for "Here& Now", I'm
Steven Potter. >> Turning to health news, the
SSM Health System recently announced plans to sell three of
their nonprofit nursing homes in Wisconsin to a for profit
company based in new Jersey, an employee at one of those
facilities shared with here and Now. A letter from the staff to
management saying they did not lead this process with integrity
or transparency, and the residents, families and staff
suffered the brunt of the consequences as a result. Now,
the sale may be part of a larger nationwide trend of nonprofit
nursing homes being sold to for profit entities. The uptick is
concerning for health workers and patients as the centers for
Medicare and Medicaid. Say for profit facilities on average,
have lower staffing and worse quality of care. Joining us to
discuss this is Barbara Bowers, founding director of the
UW-Madison School of Nursing's center for Aging Research and
Education. And thanks very much for being here. So what do you
think about the trend of for profit entities buying not for
profit facilities? >> Yeah, there's a lot involved
in that. There have always been a majority of for profit
facilities. But as you've said, the trend is increasing. There's
more and more for profit and fewer and fewer not for profit.
So one of the issues I mean, part of the question is why the
not for profits are getting out of the business and there is a,
an issue, I think, with general reimbursement from state and
federal agencies. And that would be mostly Medicare and Medicaid.
put into the system to provide the kind of care, both quality
of care and quality of life for people. That's part of it. So if
you want to take an organization that doesn't have enough money
to begin with in terms of the reimbursement level and make a
profit, you've got to get it from somewhere. And what we've
seen is that where it comes from is largely labor, and as you've
said, the staffing is lower in for profit organizations. And I
think for the staffing level is vital, not just for the quality
of care, the outcomes that we measure on a regular basis, but
also quality of life. Do you have people who answer a call
light, and how long does it take them? Are there people to talk
to? Can you are there activities that are interesting and
engaging to you? Or is it sort of the bingo for everybody?
Every night, >> so staffing shortages have
been described by people, including yourself, as a crisis,
how bad is it and what are the effects even over quality of
life? >> Yeah.
contribute to this. >> I always say to people
recruitment, which is what tends to be the focus. We need more
staff. We need to find more staff. There's not enough people
available. All of that is true. But if we retained staff at a
higher rate, we wouldn't have to worry so much about recruiting
national averages for turnover rates for the direct care
workers, the CNAS is about 70%. For nurses, it's about 40%.
Directors of nursing come and go very quickly as well, any
business and people who are out there who who run businesses
know that if you have a turnover rate of 70%, your organization
is in trouble. So it causes huge disruptions. It's also really
important issue for the residents because they get to
know people. They get to know the staff. These become their
surrogate families. And when it's constantly turning over,
they're losing these connections. These important
relationships, so I think we need to really focus a lot more
on retention. What does it take to keep staff there? And there's
actually been a fair amount of research on that. And I don't
think it's very widely used. >> So just late this week,
Governor Tony Evers announced the state will invest nearly
$260 million of Covid relief money to fund wage increases to
direct care workers in places like this and for nursing homes.
>> I think there is a huge and I have to say that home care
workers tend to get less pay even than nursing home workers,
and their benefits are less, which is also another
distinction between, in general, for profit and not for profit
homes. Is, the for profit have generally lower levels of
benefits. So, I that's wonderful that he's putting money into
that, if you look at the research on staff turnover, it's
not exclusively or even primarily money. I mean, people
know what money they're getting when they go into it. It's not
great. They could get more money, probably at a fast food
restaurant. These are people who are really committed to what
they're doing. They believe in what they're doing. They love
what they're doing, and so the money is not the most important
thing. I'm certainly not saying they shouldn't get an increase.
They certainly need a wage increase. On the other hand,
there are a lot of other things that drive people out. Part of
it is supervisors, people who supervise them, who don't have
supervisor training. And that doesn't sound like a big deal,
but it is. I mean, I know in, the research has been done on
turnover in every industry shows that the direct supervisor is
the most important factor for whether or not people stay in
their job. So that that I think we need more more of better
quality. And also training of the staff. Staff are not always
well, well enough trained to take care of the people. They're
taking care of, people leave because of the low staffing
level. I've had so many CNAs tell me that the reason they
left is at the end of the day. When they went home, they felt
really bad about I left. I mean, I remember one woman who said, I
put Edith on the toilet, and I said, I'll be back in five
minutes. And I never went back. I got so busy, distracted, I
never. And she woke up in the middle of the night horrified,
not knowing what had happened to this person, those are the sorts
of things that drive people out. >> What is your advice to
families needing long term care in this current landscape?
>> I would look at turnover rates in the nursing home, if
the retention rate, the turnover rates are low, the retention
rates are high. That says something about the quality of
the entire environment. the entire environment.