Nursing home residents’ welfare put on hold for a decade

John and Terri Hale

Last December, we wrote about the debate unfolding in courtrooms and in Congress about the needs and rights of nursing home residents vs. the needs and rights of nursing home owners.

The debate centered on whether the federal government should establish a rule requiring nursing homes that receive taxpayer funds to provide a bare minimum number of certified nurse aides and nurses to serve residents.

The federal government is the primary funder of nursing home services, to the tune of about 100 billion taxpayer dollars each year. Advocates for consumers, including us, said taxpayers should expect better results from their investment.

We argued the staffing rule was needed to ensure that nursing homes have enough staff on hand to keep residents safe, treated humanely, and free from neglect or abuse — seven days a week, 24 hours a day.

Advocates said the current rule about staff requirements was too vague and hasn’t worked. The rule, in place for decades, says that facilities must have a “sufficient” number of staff. “Sufficient” is subject to wide interpretation, and has allowed too many facilities to have too few staff to adequately serve residents.

Proof that the current rule fails residents is seen in constant headlines about poor, if not horrendous, care provided to them. Failures show up in state agency facility inspection reports, and complaints to long-term care ombudsmen’s offices and resident advocates.

The nursing home industry went on record strongly opposing a minimum staffing rule. So did 20 state attorneys general including Brenna Bird, and 14 governors including Kim Reynolds. They said there was no need for additional regulation. They claimed that any new rule requiring a minimum staffing level would be impossible to meet, too expensive to implement, and cause facilities to close.

Notably, the opponents of the rule were silent on the basic question — would having more staff on duty improve the health, safety and quality of life of residents? Every bit of research, and every bit of common sense, says the answer to that question is clearly “yes!”

Our opinion piece asked the six members of Iowa’s congressional delegation: whose side will you be on if this issue comes to a vote? Will you side with what’s best for nursing home residents, or what’s best for the largely for-profit nursing home industry? Will you side with the invisible and voiceless, or with the well-heeled and politically influential?

We now know the answer.

Senators Chuck Grassley and Joni Ernst, and House Members Ashley Hinson, Mariannette Miller-Meeks, Zach Nunn and Randy Feenstra all voted against nursing home residents and for business interests.

By joining their Republican colleagues in recently passing the so-called One Big Beautiful Bill, they voted to delay the minimum staffing rule for 10 years! A full decade will go by without a specific requirement that nursing homes always have a bare minimum of certified nurse aides and nurses on duty.

In doing so, these elected leaders sent an unmistakable message to nursing home residents and their families — we really don’t care about you. You should accept poor if not inhumane care, and wait for up to 10 years to see improvement.  That message was sent to Iowans like these:

• The 90-year-old woman in Northeast Iowa who sat on the toilet for two hours before any staff were available to help her get back to bed.
• The elderly central Iowa man who choked to death while eating because there wasn’t enough staff to assist him.
• Residents in multiple Iowa nursing homes who have been subjected to physical or sexual abuse by other residents because there wasn’t an adequate number of staff members monitoring rooms.

The six members of Iowa’s congressional delegation, plus Brenna Bird and Kim Reynolds, apparently believe that this type of care is tolerable. How in the world can they — or anyone — view harm, neglect, abuse and death of Iowa’s most vulnerable as OK? We shake our heads in bewilderment and disgust.

By their words and their votes, these elected representatives have shown Iowans who they are and what they care about.

Now Iowans should show them something — the door. They simply do not deserve our support, or our votes.

John and Terri Hale own The Hale Group, an Ankeny-based firm advocating for older Iowans and the caregivers who support them. Contact: terriandjohnhale@gmail.com