Biden wants a federal minimum staffing requirement for nursing homes

Biden wants a federal minimum staffing requirement for nursing homes

　　Transcript¹

　　The Biden administration aims to establish minimum staffing requirements for nursing homes — part of a push to improve care for residents. Doing so amid staffing issues could prove challenging.

　　STEVE INSKEEP, HOST:

　　The Biden administration wants to change the rules for nursing homes. Many don't have enough staff. So the White House wants a federal minimum staffing requirement, which may be easy to say and hard to do. Here's NPR's Andrea Hsu.

　　ANDREA HSU, BYLINE²: Holly³ Ward⁴ has worked as a geriatric nursing assistant in Baltimore for four years. On some days, she has 13 residents in her care to dress, feed, clean, change, move - one after another.

　　HOLLY WARD: So it becomes like an assembly line.

　　HSU: And not one that runs smoothly⁵. She'll find that while she's attending to one resident - say, Mr. Smith - Mr. Jones is incontinent.

　　WARD: Well, I can't do Mr. Smith and do Mr. Jones at the same time.

　　HSU: So Mr. Jones has to wait in soiled bedclothes, sometimes for a while. It's not the kind of care Holly Ward wants to deliver to her residents.

　　WARD: Because to care for them, you have to give them dignity, yet you don't give us the staff to provide that.

　　HSU: Often, important things just don't get done - talking with the residents, providing emotional support.

　　WARD: They look to you for comfort. But then when you don't have time to adequately give them the comfort that they deserve, it's not fair. And then it's on your conscience.

　　HSU: Where Ward works is actually better staffed than most nursing homes. At the last place she worked, sometimes she'd have 16 or 18 residents to care for.

　　Now, the federal government does have some staffing requirements for nursing homes, but the core language is vague. Essentially⁶, nursing homes must have sufficient staff so that residents can live their best lives. Over the years, advocates have said that is not enough, and the Biden administration agrees. Chiquita Brooks-LaSure heads the Centers for Medicare & Medicaid Services.

　　CHIQUITA BROOKS-LASURE: We think it's really important to set a very specific standard that can be measured again - to really make sure that staff is adequate to ensure quality.

　　HSU: So Brooks-LaSure says her agency wants to figure out, how much staff should nursing homes be required to have? - and then enforce that with a rule.

　　BROOKS-LASURE: We've talked about having standards in place within the year.

　　HSU: Numerous studies have shown that understaffing nursing homes can harm the health of residents. You see more bedsores, more weight loss, overprescribing of antipsychotic medications and, in the pandemic, more COVID.

　　But nursing home staffing is not just a pandemic issue. Maurice Miller⁷ will tell you that. He's 59 years old, and he's lived in a nursing home in Takoma Park, Md., for almost a decade.

　　MAURICE MILLER: I am a functional⁸ quadriplegic as a result of my stroke.

　　HSU: He relies on the staff to feed him and clean him and change his hospital gown and to make sure his computer is charged and within reach. There are good days when there's enough staff to meet all his basic needs. But then there are bad days.

　　MILLER: It's a bad day when I am in pain and I'm not going to get relief in a timely fashion.

　　HSU: Miller says it could be 45 minutes before someone's able to respond to his call button. It's a bad day when he cannot talk to his 94-year-old mother because his laptop, which he operates through dictation, has been pushed out of reach and no one's available to get it for him.

　　MILLER: And it's a bad day if my roommate is in crisis of some sort. Those are really, really bad days because you're watching someone actually suffer.

　　HSU: Some days, Miller is told there are not enough staff to move him to his wheelchair, even though his doctor says time out of bed helps his blood pressure, his circulation and his mental health.

　　MILLER: Because I'm not trapped within these four walls.

　　HSU: Losing wheelchair time, he says, could result in a downturn in his health. In fact, Maryland, where Maurice Miller lives, does have a minimum staffing requirement for nursing homes, as do most states. But they are all lower than what the federal government recommended two decades ago, the last time they studied this issue. Back then, they said each resident should receive at least 4.1 hours of direct care per day. The only place that has adopted that guidance is Washington, D.C., which is where I find Mary Ajiboye.

　　MARY AJIBOYE: Good morning, Charity. How are you?

　　HSU: Ajiboye is the staffing coordinator⁹ at Forest Hills of D.C. It's a nursing home with about a hundred residents. She sits in a small office with a computer and a phone.

　　AJIBOYE: As usual, this is Mary calling from Forest Hill of D.C. I'm trying to find out if you're available to help me tomorrow morning.

　　HSU: Her job, all day, every day, is to go down a list of nurses and nursing assistants to fill gaps in the schedule. It's not an easy task.

　　AJIBOYE: Oh, this your weekend to work at other job?

　　HSU: Charity is not available, so Ajiboye's search continues. Her boss, Tina Sandri, the CEO of Forest Hills of D.C., says staffing takes highest priority.

　　TINA SANDRI: We think about meeting the numbers every single day. It was a daily struggle before COVID. It is even more so now.

　　HSU: Turnover¹⁰ at Forest Hills is nearly triple what it was before the pandemic. There is competition for workers like never before.

　　SANDRI: In D.C., you can work for Amazon at $19 an hour. You can be a dog walker for 18 an hour.

　　HSU: Sandri says they can't even get nursing assistants in the door for interviews. Nationwide, nursing homes are down more than 230,000 workers since the start of the pandemic. Sandri says she can't raise wages for nursing assistants, who typically start at minimum wage - 15, 20 an hour. As a nonprofit, she says, Forest Hills of D.C. just doesn't have the bandwidth to do so.

　　SANDRI: We don't have the bottom line.

　　HSU: So she's meeting D.C.'s staffing requirements by working her staff to the bone - her words.

　　SANDRI: They're tired. They're burnt out. They're physically¹¹ exhausted¹². And even committed people in this industry will turn around and say, I don't know how much longer I can do this.

　　HSU: As for a federal minimum staffing requirement, she's opposed. Why hold facilities to a number when there aren't people to fill the jobs?

　　Chiquita Brooks-LaSure at the Centers for Medicare & Medicaid Services says she's listening to industry concerns, including their call for more money to keep up with rising costs, especially labor¹³. But she's also looking into...

　　BROOKS-LASURE: Are we using our dollars well? Are they going to direct care?

　　HSU: To the well-being¹⁴ of nursing home residents. Maurice Miller doesn't blame the staff who have left his facility in recent weeks for other jobs. Post-COVID, he says, it's time for them to take care of themselves. But he is appealing to younger people to consider a job in a nursing home.

　　MILLER: You have an opportunity to save my life, and you have an opportunity to turn this industry on its head.

　　HSU: Something he hopes to see in his lifetime.

　　Andrea Hsu, NPR News.

　　(SOUNDBITE OF SERGEY CHEREMISINOV'S "SEVEN LIGHTS")

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 holly   

n.[植]冬青属灌木

参考例句：

• I recently acquired some wood from a holly tree.最近我从一棵冬青树上弄了些木料。
• People often decorate their houses with holly at Christmas.人们总是在圣诞节时用冬青来装饰房屋。

4 ward   

n.守卫，监护，病房，行政区，由监护人或法院保护的人（尤指儿童）；vt.守护，躲开

参考例句：

• The hospital has a medical ward and a surgical ward.这家医院有内科病房和外科病房。
• During the evening picnic,I'll carry a torch to ward off the bugs.傍晚野餐时，我要点根火把，抵挡蚊虫。

5 smoothly   

adv.平滑地，顺利地，流利地，流畅地

参考例句：

• The workmen are very cooperative,so the work goes on smoothly.工人们十分合作，所以工作进展顺利。
• Just change one or two words and the sentence will read smoothly.这句话只要动一两个字就顺了。

6 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

7 miller   

n.磨坊主

参考例句：

• Every miller draws water to his own mill.磨坊主都往自己磨里注水。
• The skilful miller killed millions of lions with his ski.技术娴熟的磨坊主用雪橇杀死了上百万头狮子。

8 functional   

adj.为实用而设计的，具备功能的，起作用的

参考例句：

• The telephone was out of order,but is functional now.电话刚才坏了，但现在可以用了。
• The furniture is not fancy,just functional.这些家具不是摆着好看的，只是为了实用。

9 coordinator   

n.协调人

参考例句：

• The UN Office for the Coordination of Humanitarian Affairs, headed by the Emergency Relief Coordinator, coordinates all UN emergency relief. 联合国人道主义事务协调厅在紧急救济协调员领导下，负责协调联合国的所有紧急救济工作。
• How am I supposed to find the client-relations coordinator? 我怎么才能找到客户关系协调员的办公室？

10 turnover   

n.人员流动率，人事变动率；营业额，成交量

参考例句：

• The store greatly reduced the prices to make a quick turnover.这家商店实行大减价以迅速周转资金。
• Our turnover actually increased last year.去年我们的营业额竟然增加了。

11 physically   

adj.物质上，体格上，身体上，按自然规律

参考例句：

• He was out of sorts physically,as well as disordered mentally.他浑身不舒服，心绪也很乱。
• Every time I think about it I feel physically sick.一想起那件事我就感到极恶心。

12 exhausted   

adj.极其疲惫的，精疲力尽的

参考例句：

• It was a long haul home and we arrived exhausted.搬运回家的这段路程特别长，到家时我们已筋疲力尽。
• Jenny was exhausted by the hustle of city life.珍妮被城市生活的忙乱弄得筋疲力尽。

13 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

14 well-being   

n.安康，安乐，幸福

参考例句：

• He always has the well-being of the masses at heart.他总是把群众的疾苦挂在心上。
• My concern for their well-being was misunderstood as interference.我关心他们的幸福，却被误解为多管闲事。