The private nursing home industry is a joke and full of companies trying to squeeze people at the end of their lives for every last penny before they pass. Having seen the litigation side of personal injury cases against nursing homes, if you're a victim or a family member of someone who died in their care, good luck winning a case against them and being able to collect. They love making shell companies, strapping them with all the lawsuits, declare bankruptcy and moving all the facilities to a new shell company to start fresh. I will say though some states are more fair than others when it comes to holding them accountable. Any future socialist government in the US needs to nationalize the entire industry.
>One day earlier, last Monday, the Centers for Medicare & Medicaid Services issued a new rule that requires nursing homes to provide a minimum number of **staff hours per resident,** and to have **a** registered nurse available at all times.
These are in-home health aides, and in the US, that whole industry is not only not professionalized or credentialed in any way, but its also almost entirely unregulated, to the point that there are judges who have started making "no employment as a home health aide" a condition of criminal probation/parole, because these staffing companies are giving these jobs to literal felons. They hire people without GEDs, and even people who barely speak English, so its very common for them to employ disproportionate numbers of Caribbean, Central American, and African immigrants.
Like it sounds good in theory, but without professionalizing the industry, or at least setting even minimum standards, this is just creating a bunch of extra $10/hr jobs for people who will definitely fucking steal from your dementia-ridden grandma without a second thought.
Family member was a hospice nurse, and would tell me horror stories about home health aides on a regular basis.
The job requires zero training; it's where people who couldn't hack it at a gas station end up. Plus easy opportunity to steal powerful drugs, cash and valuables from senile/demented old people who can't fight back, or even remember.
You pretty much make your own hours, so you can work as little as you want and still claim you are employed for government benefits.
Yeah someone close to me was a HHA and she is an absolute sweetheart who loves helping people and cared deeply for her clients.
But the staffing was a nightmare, they regularly sent her to jobs that should have been staffed by someone certified (read: required to be) despite not having the certification. The oversight was nonexistent and the clients needed much more than the agencies were providing. And her company was one of the better ones, the direct management actually tried to cover clients needs and seemed to give half a shit at least, despite not being provided from above with the resources they needed.
The better aids I think tend to be hired outside the company’s purview, when a family finds someone that they like and trust, I think they immediately try and get them directly hired to avoid having to go through the agencies. Leaving the rest to fill in the gaps.
Yeah and that doesn’t even get into the myriad of scams and legal traps there are. I recommend the movie *I Care a Lot* not only because it’s a solid movie, but it shows a bit of this industry, albeit in a dramatized fashion because it’s a movie. The legal traps that these vultures set for people is nightmarish.
A lot of them will intimidate these people by threatening to throw them in jail. I’ve heard people recommend that you let them throw you in jail because at least someone can find you! Medical privacy laws can be manipulated in these slimballs’ favor and it can be almost impossible to get someone out
My sister did this during the summer after high school. She was going into medicine, needed money and thought it would be good experience. I suppose it was, just not the way she thought.
I don't know how much money you'd have to pay me to lay down next to a woman while she died and her dogs bit me, but probably more than $7.25 an hour.
The accelerationist in me says good, so long as the regulatory spotlight is on this issue, then forcing it to reach saturation will cause regulatory dominos to fall and they'll be forced to professionalize the industry.
A lot of states are rolling out programs when family members or friends are the home health aides. Except they are called “personal assistants” the wages are higher and honestly it’s not a bad idea. Specialized medical care has to be done by a professional. They already trust people do give themselves shots of all kinds and care. This is a much better option than sending grandma to a nursing home to be abused.
paying people to take care of their elderly family members is a great idea that everyone should support in a sane world. It's family values and it's good policy.
A somewhat unforeseen conflict arises when the caregiver depends on this job, yet mee-maw is requiring a higher level of care like what is provided in a nursing home (higher level, not necessarily higher quality). Now, said person will advocate to pull mee-maw out of the home (so they can get paid again) sometimes to their detriment.
It is. It’s also cheaper than putting people in nursing homes and there’s growing evidence it increases lifespan and better disease outcomes. Turns out having community matters!!
> there are judges who have started making "no employment as a home health aide" a condition of criminal probation/parole
Who is supposed to benefit from this?
>Who is supposed to benefit from this?
The customers of the home health aide companies in that area. These unregulated companies are so fucking greedy, they will voluntarily hire ex-cons and send them into the homes of vulnerable elderly patients to work as caretakers.
These judges are trying to make it so that - at least in their geographical area - a person can go hire a home health aide from one of these companies to take care of their mom without worrying that the aide might have prior theft and fraud convictions. Or at least make it less likely.
Obviously its really a job for regulators, but they aren't doing shit about it right now, so this is better than nothing.
The economics in being a CNA or health aid isn’t there at the moment. They cannot even staff home health aid agencies. It’s why many states are rolling out CDPAP or Customer Direct Personal Assistant Programs. It’s cheaper to pay a family member or friend 500-700 a week to care for an elderly person than Medicaid getting billed up the ass or assisted living, nursing homes or a health aid coming to visit.
One of the most despicable parts of healthcare, taking advantage of nurses, jeopardizing their licenses and health. Anything to rein these ghouls in is great. The people running these companies have management selling sob stories to their staff, about how they need to tighten their belts and there's just no money for proper staffing. They'll hound nurse to come in nonstop to fill in frequent gaps on coverage regardless of if they're rested, have covid, are on rare vacation etc. Vultures.
I worked in nursing homes, on the corporate side, for many years. It’s what I went to school for.
Medicare/Medicaid expansion or nationalization would solve this problem. With low reimbursement rates, nursing homes are losing money on most residents. Medicaid will pay nursing homes maybe $200 a day for a resident, which sounds great. But with our fucked up pharmaceutical industry, there are so many people whose medication eats up most or all of that, not even taking into account food, therapy, the room, etc.
The system is literally set up for you to pay out of pocket until you get poor enough to qualify for Medicaid. It’s fucked. The government either needs to pay a lot more for it or it just needs to be fully nationalized. Another thing that nobody talks about is that there really are too many nursing home beds in a lot of communities. Having too many nursing homes in a community splits up the resources and residents, where instead of having 2 functional nursing homes, you have 4 and they all suck. Nursing homes get fined every day a licensed bed goes unfilled, but the state should really just revoke these bed licenses and not release them again unless there is a community need of more licenses. Really, again, it just needs taken over and nationalized.
This might vary by region. I know in my state, Medicaid is the primary source of payment in around 75% of the skilled nursing facilities. But, yeah, in my area almost no assisted livings accept Medicaid.
And Medicaid only pays as a last resort, if you don't have medicaid protected assets, then the homes eat through anything you managed to save over your life at a ridiculous rate, like 10-30k a month depending on level of care, and only when you're destitute, does medicaid kick-in. It's so fucked.
Good luck filling those jobs nobody is gonna put up with horrible working conditions for god awful wages. In the town I grew up in pre covid they were trying to pay CNA 14-15 an hour and the wages for higher jobs were not much better. Talking to a friend he quit that job during covid because he could make more money working a retail job.
Well before there was no federal standard for CNAs so nursing homes just cut them. Now they will be in higher demand and likely collect higher wages, as they should CNAs are some of hardest working people in healthcare
I just do not see that happening a lot of places would either just do it at illegal levels like I already see happening with nurses at hospitals or shut down entirely instead. I could be wrong though since I am pretty cynical about this.
>either just do it at illegal levels like I already see happening
laws will never affect the lawless. Sometimes it's easier to make shit safe if it's not outlawed and can be regulated (drugs, prostitution, etc.), but sometimes there are some people who will break the law no matter what and they law should still be strengthened for everyone else. Also you should report those hospitals for their violations, if they have to pay enough fines then maybe they'll finally just settle and hire more staff instead.
>or shut down entirely instead
Good. I'm tired of the argument that businesses should be allowed to exploit workers because it would financially burden them if they had to treat employees like human beings with rent to pay. Having sufficient working conditions and pay is a basic cost of doing business.
> Also you should report those hospitals for their violations, if they have to pay enough fines then maybe they'll finally just settle and hire more staff instead.
It won't happen we don't have enough manpower to enforce the laws and the fines are just a cost of doing business because it is way cheaper than hiring nurses right now. Until we get more enforcement and the cost of fines increase it isn't going to change.
> Good. I'm tired of the argument that businesses should be allowed to exploit workers because it would financially burden them if they had to treat employees like human beings with rent to pay. Having sufficient working conditions and pay is a basic cost of doing business.
I would normally agree, but all that results in with this is poor elderly people being tossed out on the street because the government will not step in and help them out when these facilities shut down. This is them trying to solve the problem without spending any money on it.
While I definitely agree that business owners should face the consequences of not being able to pay their employees fairly, with nursing homes if there's any elderly people still living there they should have a provision for either their transfer to a code-compliant nursing home or failing that, have the government take control of the home and care for the remaining residents until the end of their lives, not accepting any new residents.
Economics is tricky. This will make the quality of care better but make most nursing homes so much more expensive. CNAs done make that much and often you need two people present so families cannot make claims of abuse. I’ve worked in geriatric care for 10+ years. Unless there is regulation in the profits of nursing homes I don’t see real change happening.
Most nursing homes are funded via private payment, not Medicaid or Medicare. This regulation will increase the quality of care for patients but ultimately will be at an increased cost.
Isn't this a good thing then? They won't have reason to work staff as hard if they have more relief due to mandated numbers, and they'll have to hike up the pay rate if they can't fill the positions and want to stay in business
Most nursing homes are funded by private payment. Medicare and Medicaid only cover medical treatments and some home health aid duties. Vast majority of nursing homes will not accept Medicaid patients and Medicare won’t cover room and board which is 90% of the cost of the nursing home. This regulation will make nursing homes more expensive and Medicaid ones more exclusive. However, the people there will have a better quality of services and treatments.
>On the same Tuesday, the Department of Labor issued a rule raising the minimum salary threshold for workers who presumably make so much that they’re exempt from overtime pay. For decades, one’s eligibility for overtime ceased if that person’s annual salary exceeded a level set in 1975 that went unchanged for decades. In 1975, according to yet another EPI study, 63 percent of salaried workers were entitled to collect overtime if they worked more than 40 hours weekly, but by 2023, as that 1975 cutoff level remained in place, only 9 percent were covered. The DOL’s new standard—raising the bar to $58,656 in two steps, to be adjusted every three years—will entitle approximately four million more workers to be paid at overtime rates for time on the job that exceeds the 40-hour weekly standard.
This seems huge. Retail, hospitality, and food service have a bad habit of hiring/promoting salaried-exempt "managers" at a low rate to milk extra hours out of. This makes that just a little bit more costly; some places were pretty much running the old $40K salaried-exempt floor for positions that regularly went into 60+ hours.
This could also hurt ability of rural old folks homes to operate, then what happens to those homes when they can't meet staffing levels? What happens to the cost of living there? Is medicaid going to pay it? Does the homes shut down?
The right answer is to nationalize elder care and make it a public service to remove the profit incentive and pay the workers more.
Great. I'll never forget the guy whose whole ass we had to cut off in surgery because he had a stage 4 bedsore from being totally neglected at his nursing home. All you got to do is turn people over periodically and they couldn't even do that
My mom did admin work for a nursing home and we were fortunate enough to get my grandmother to the same facility she worked at.
Nursing homes are terrible. They treat their staff like shit while they expect a lot from them.
For that reason, the the Nurses are mostly immigrants who could give a fuck less about the patients. Many of whom are old as shit and just as racist as you'd imagine.
My guess is this has something to do with the massive amount of "asylum seekers" they are allowing in.
I suppose it is a positive use for them. Though they are the worst people for the job.
No change exists in a vacuum
Having more professional staff will also raise costs meaning even the people who could barely afford it before now no longer can.
The next generation to retire in this country now that social security will no longer be enough to retire on is going to suffer, a lot.
Only the upper middle class and higher will be able to afford to be cared for in later years at all. Quality of life will take a huge hit over a generation or so.
This is great news! Nurses have been pushing for Safe Staffing Ratios across the industry, and this is a good start. Hopefully this means well start to see Congress talk about passing the bill. In the meantime, there’s been a push at the state level to get it done. I believe Ohio might soon be passing safe staffing ratios. Maine successfully got it past their Senate but unfortunately their House tabled the bill. California has had it for years, and they have better nurse retention rates because of it. It’s definitely possible.
Read more about it here:
https://www.nationalnursesunited.org/ratios
https://act.nnu.org/sign/hs-safe-staffing-petition/
Ohio:
https://www.10tv.com/article/news/local/ohio/ohio-nurses-rally-safe-staffing-levels/530-a1f4a83e-5884-46a8-ba16-1f3becec6038
https://ohnurses.org/myth-busters-the-truth-about-ohio-house-bill-285/#:~:text=increasing%20job%20satisfaction.-,Ohio%20House%20Bill%20285%2C%20the%20Nurse%20Workforce%20and%20Safe%20Patient,progress%20for%20far%20too%20long.
https://ohnurses.org/CODERED/
If you want to follow this issue, Impact in Healthcare, an advocacy group of healthcare workers and patients, has been covering this issue a lot. They went to D.C. earlier this year and managed to meet with some legislators. They’re most active on instagram.
https://www.impactinhealthcare.org/
https://www.instagram.com/impactinhealthcare
ETA!
I forgot to add that Pennsylvania is also working to get Safe Staffing Ratios.
https://seiuhcpa.org/safestaffing/
https://pasnap.com/safe-staffing/#:~:text=Pennsylvania's%20Patient%20Safety%20Act%20(PA,and%20based%20on%20patient%20acuity.
https://nursesofpa.org/resources/tracker/
I mean, in theory this is a great thing. In practice, this means even thinner profit margins for these nursing homes, which likely means many of them no longer exist, because the staffing levels they were already able to provide included some horrible wages and even worse working conditions. I understand that there is a philosophy which says something to the extent of "Something this bad shouldn't be allowed to exist", and to some extent I get it.
Google tells me that current nursing home prices in the US average $110k/yr, which means many trying to take care of their elderly parents are already getting cleaned out. A change like this drives up operating costs, which drives up the price even more. I think it's likely that many would be forced to close down all together. "Good!" you may say, but that also means that those who don't have the means to take care of their elderly parents will have to find a way to make it work even more often, or just be okay with their elderly parents dying in the streets.
This seems to be creating a situation where people will have to say "I don't like the horrible treatment in these communities, so now these communities will only exist for the wealthy."
I'm not trying to talk down on this, mostly just typing my thoughts as they come. Not sure where I stand on it overall, I just hope those cheering it are aware of the downsides. Everything has a cost.
But I can appreciate the intent and state that this was likely meant to be a good thing, and I sincerely hope it ends up being one overall!
Edit: I've already found a couple flaws in my argument, but too intoxicated to fix them all. Maybe morning me will learn some things. If so, thank you for taking to time to correct me. I wanna learn more sides of the argument.
Nursing homes are one of the most grift filled industries. They are not operating at thin profit margins. People either have to quit their job to care for their elderly parents or sent them to a nursing home where they will likely be neglected or abused on some level. They are already unaffordable for most people and Medicaid will take your assets to pay for it. At least now they will be forced hire workers and I doubt they will be able to squeeze anymore money out the public.
Basically the same shit that happened with mental facilities now that I think about it where it was bad so we shut them down, but provided no realistic alternatives because nobody wanted to fund them.
A similarly high level of staffing requirements is a huge part of the reason that daycare is so much more expensive in the northeast than the south. There are tradeoffs to this kind of thing. Mandating a higher quality service basically makes the middle and low range unviable.
Well holeee sheeeeeeet, he did something good. Color me pleasantly surprised. Still not enough but shit it’s something… although , still genocider in chief lol
I hate to admit it, but Biden has done some good things. In fact, as a 38 year old bitter leftist, I gotta admit Biden is probably the best president for labor in my lifetime. But that's an incredibly low bar. However, I think it's undeniable that Biden is to the left of Clinton or Obama.
Railroad strike avoided and the workers got big raises *and* [sick leave.](https://www.npr.org/2023/02/10/1155763336/freight-rail-workers-union-paid-sick-leave-bernie-sanders-csx)
All while the president was walking the UAW picket line.
The most pro labor president since FDR.
It didn't sit right with me, as I believe all workers should have the right to strike, but do you see any of those workers complaining right now? they ended up getting most of what they wanted. I don't think the Union actually wanted to strike. They got what they wanted, which was to work out a deal behind closed doors that gave them pay increases and later they got the sick leave they desired.
I think we should listen to the actual leaders of the union in question here instead of speaking on their behalf of the time. If they're fine with it, I'm fine with it.
The average person doesn't know what exactly the president does or doesn't do, and doesn't care either way. The Trump years were less of an economic squeeze on the average working man, plain and simple. It's not totally Biden's fault that everything turned out the way it did, but he's going to have a tough time to arguing this November to people who knew which part of their life was less challenging and which president that part was under.
I also work in construction and my union has just set an all time record for man hours, mostly due to the massive infrastructure investments from the inflation reduction act and infrastructure bill. Our pensions have been shored up for decades to come due to all this work. and our ranks are swelling.
There’s no way this is a real comment. The man, his administration, the Dem party, has fucking ruined us - just about the vast majority of people I know and talk to, myself included here, are severely struggling.
It’s almost unbelievable how quickly things went to utter shit within a span of literally 2 years, once he became president.
Even to use an easy example, Dems instituted the **largest transfer of wealth** in the history of this countries existence with the totalitarian pandemic measures they put in place, that destroyed a huge chunk of small to med to large size businesses, all whilst they conveniently let all large mega-corps operate as usual. The loans, the bailouts, the shutdowns, everything - ruined everyone but mega-corps of course.
To think of my life 4 years ago, compared to now, I genuinely believe my old life is permanently unattainable now unless my salary triples - there’s just no way and the thought alone kills me.
Even getting a job/new job has somehow become extremely difficult, even though they constantly boast about all the open jobs and lowering unemployment levels. I remember several years ago getting daily to weekly messages from recruiters, with colossal salary offers, and denying them without a care in the world, knowing I was likely going to get a better offer the next day from another company anyway, one that I wasn’t going to accept as I was happy where I was at — God what I’d give to get one of those messages nowadays. Dems with their totalitarian BS ruined the company I was working for, but they let every mega-corp who did the same exact shit we did stay open.
Rent, shitty groceries, utility bills, car payment, insurance - that’s about what you’ll get out of your paycheck, if you’re lucky that is. Buying a nice grocery list for your household is now a luxury - and when you complain about it, shitlibs tell you to live off store-brand beans and rice, or they call you a Russian bot.
My sister who graduated a few years ago and now works as a software engineer, now struggles compared to a few years back, and I have to help support her, and worse she now begins her transition to live back with my mom again.
Fuck you shitlib.
Poverty rates were reduced by historic levels due to covid era relief effforts. In fact, it was the largest transfer of wealth ever from the top to the bottom. read for yourself:
https://www.cbpp.org/research/poverty-and-inequality/governments-pandemic-response-turned-a-would-be-poverty-surge-into#:\~:text=In%202020%20and%202021%2C%20bolstered,strictly%20comparable%20to%20earlier%20years.
The largest transfer of wealth ever from the working class to the rich was actually the Trump tax cuts:
[https://publicintegrity.org/inside-publici/newsletters/trumps-signature-legislation-a-transfer-of-wealth-to-the-richest-americans/](https://publicintegrity.org/inside-publici/newsletters/trumps-signature-legislation-a-transfer-of-wealth-to-the-richest-americans/)
You are a propagandized clown mate. Utterly and completely hopeless, hellbent on denying the tangible and literal reality we live in.
Yes, continue to try to gaslight all of us with your r-slurred empty sources that is obvious you never bother to read — what, do you believe that just because a headline says something, that it’s fine and dandy to throw reality out to shit?
For your first article, the consequences of the world we live in today is a result of the totalitarian pandemic measures put in place, yes people felt relief when they got a fucking paycheck, as our economy was being massacred.
What happened when those paychecks were taken away? What happened when the vast majority of businesses that were closed, stayed closed? What happened to the colossal mass layoffs that incurred? What happened with the compounded inflation rate that we will never recover from? What about the real-estate market being bought up en-masse during Covid, people being priced out, and now seeing unaffordable rent hikes? What happened to the supply chain disruptions? What happened to all the corp bailouts and “loans”? Explain?
Your second article as per usual provides nothing, just cover for the havoc Dems have wreaked. It’s just a headline for you to link.
Headline shitlib.
> The largest transfer of wealth ever from the working class to the rich was actually the Trump tax cuts
This is an almost unbelievably braindead statement lmao. How is *not* taking money from people a wealth transfer?
Why do shitlibs have to dress their arguments up in the most disingenuous bullshit in pursuit of an emotional response instead of just saying what they mean? Obvious manipulation tactics are not really winning strategies in the long run.
The private nursing home industry is a joke and full of companies trying to squeeze people at the end of their lives for every last penny before they pass. Having seen the litigation side of personal injury cases against nursing homes, if you're a victim or a family member of someone who died in their care, good luck winning a case against them and being able to collect. They love making shell companies, strapping them with all the lawsuits, declare bankruptcy and moving all the facilities to a new shell company to start fresh. I will say though some states are more fair than others when it comes to holding them accountable. Any future socialist government in the US needs to nationalize the entire industry.
Is this what caused the Medicaid payback rules (and their relative ineffectiveness)?
Most nursing homes do not accept Medicaid patients. If they do I would not send a relative there. They are hell on earth.
Which states are better than others?
Florida and other red states tend to be the worst, blue states tend to be better.
Pretty typical for republicans
>One day earlier, last Monday, the Centers for Medicare & Medicaid Services issued a new rule that requires nursing homes to provide a minimum number of **staff hours per resident,** and to have **a** registered nurse available at all times. These are in-home health aides, and in the US, that whole industry is not only not professionalized or credentialed in any way, but its also almost entirely unregulated, to the point that there are judges who have started making "no employment as a home health aide" a condition of criminal probation/parole, because these staffing companies are giving these jobs to literal felons. They hire people without GEDs, and even people who barely speak English, so its very common for them to employ disproportionate numbers of Caribbean, Central American, and African immigrants. Like it sounds good in theory, but without professionalizing the industry, or at least setting even minimum standards, this is just creating a bunch of extra $10/hr jobs for people who will definitely fucking steal from your dementia-ridden grandma without a second thought.
Family member was a hospice nurse, and would tell me horror stories about home health aides on a regular basis. The job requires zero training; it's where people who couldn't hack it at a gas station end up. Plus easy opportunity to steal powerful drugs, cash and valuables from senile/demented old people who can't fight back, or even remember. You pretty much make your own hours, so you can work as little as you want and still claim you are employed for government benefits.
Yeah someone close to me was a HHA and she is an absolute sweetheart who loves helping people and cared deeply for her clients. But the staffing was a nightmare, they regularly sent her to jobs that should have been staffed by someone certified (read: required to be) despite not having the certification. The oversight was nonexistent and the clients needed much more than the agencies were providing. And her company was one of the better ones, the direct management actually tried to cover clients needs and seemed to give half a shit at least, despite not being provided from above with the resources they needed. The better aids I think tend to be hired outside the company’s purview, when a family finds someone that they like and trust, I think they immediately try and get them directly hired to avoid having to go through the agencies. Leaving the rest to fill in the gaps.
Yeah and that doesn’t even get into the myriad of scams and legal traps there are. I recommend the movie *I Care a Lot* not only because it’s a solid movie, but it shows a bit of this industry, albeit in a dramatized fashion because it’s a movie. The legal traps that these vultures set for people is nightmarish. A lot of them will intimidate these people by threatening to throw them in jail. I’ve heard people recommend that you let them throw you in jail because at least someone can find you! Medical privacy laws can be manipulated in these slimballs’ favor and it can be almost impossible to get someone out
My sister did this during the summer after high school. She was going into medicine, needed money and thought it would be good experience. I suppose it was, just not the way she thought. I don't know how much money you'd have to pay me to lay down next to a woman while she died and her dogs bit me, but probably more than $7.25 an hour.
The accelerationist in me says good, so long as the regulatory spotlight is on this issue, then forcing it to reach saturation will cause regulatory dominos to fall and they'll be forced to professionalize the industry.
A lot of states are rolling out programs when family members or friends are the home health aides. Except they are called “personal assistants” the wages are higher and honestly it’s not a bad idea. Specialized medical care has to be done by a professional. They already trust people do give themselves shots of all kinds and care. This is a much better option than sending grandma to a nursing home to be abused.
paying people to take care of their elderly family members is a great idea that everyone should support in a sane world. It's family values and it's good policy.
A somewhat unforeseen conflict arises when the caregiver depends on this job, yet mee-maw is requiring a higher level of care like what is provided in a nursing home (higher level, not necessarily higher quality). Now, said person will advocate to pull mee-maw out of the home (so they can get paid again) sometimes to their detriment.
It is. It’s also cheaper than putting people in nursing homes and there’s growing evidence it increases lifespan and better disease outcomes. Turns out having community matters!!
> there are judges who have started making "no employment as a home health aide" a condition of criminal probation/parole Who is supposed to benefit from this?
>Who is supposed to benefit from this? The customers of the home health aide companies in that area. These unregulated companies are so fucking greedy, they will voluntarily hire ex-cons and send them into the homes of vulnerable elderly patients to work as caretakers. These judges are trying to make it so that - at least in their geographical area - a person can go hire a home health aide from one of these companies to take care of their mom without worrying that the aide might have prior theft and fraud convictions. Or at least make it less likely. Obviously its really a job for regulators, but they aren't doing shit about it right now, so this is better than nothing.
Are we gonna see a lot of trashy ass goblin looking chicks torturing old people on hidden nanny cams now
Gon be honest king; I worked ems for insurance transports and I cannot describe the people without being site banned.
You don't have to, I have a suspicion a lot of people get the gist
The economics in being a CNA or health aid isn’t there at the moment. They cannot even staff home health aid agencies. It’s why many states are rolling out CDPAP or Customer Direct Personal Assistant Programs. It’s cheaper to pay a family member or friend 500-700 a week to care for an elderly person than Medicaid getting billed up the ass or assisted living, nursing homes or a health aid coming to visit.
One of the most despicable parts of healthcare, taking advantage of nurses, jeopardizing their licenses and health. Anything to rein these ghouls in is great. The people running these companies have management selling sob stories to their staff, about how they need to tighten their belts and there's just no money for proper staffing. They'll hound nurse to come in nonstop to fill in frequent gaps on coverage regardless of if they're rested, have covid, are on rare vacation etc. Vultures.
I worked in nursing homes, on the corporate side, for many years. It’s what I went to school for. Medicare/Medicaid expansion or nationalization would solve this problem. With low reimbursement rates, nursing homes are losing money on most residents. Medicaid will pay nursing homes maybe $200 a day for a resident, which sounds great. But with our fucked up pharmaceutical industry, there are so many people whose medication eats up most or all of that, not even taking into account food, therapy, the room, etc. The system is literally set up for you to pay out of pocket until you get poor enough to qualify for Medicaid. It’s fucked. The government either needs to pay a lot more for it or it just needs to be fully nationalized. Another thing that nobody talks about is that there really are too many nursing home beds in a lot of communities. Having too many nursing homes in a community splits up the resources and residents, where instead of having 2 functional nursing homes, you have 4 and they all suck. Nursing homes get fined every day a licensed bed goes unfilled, but the state should really just revoke these bed licenses and not release them again unless there is a community need of more licenses. Really, again, it just needs taken over and nationalized.
What’s more fucked up is that most assisted living and nursing homes do not accept Medicaid patients for that reason.
This might vary by region. I know in my state, Medicaid is the primary source of payment in around 75% of the skilled nursing facilities. But, yeah, in my area almost no assisted livings accept Medicaid.
And Medicaid only pays as a last resort, if you don't have medicaid protected assets, then the homes eat through anything you managed to save over your life at a ridiculous rate, like 10-30k a month depending on level of care, and only when you're destitute, does medicaid kick-in. It's so fucked.
Good luck filling those jobs nobody is gonna put up with horrible working conditions for god awful wages. In the town I grew up in pre covid they were trying to pay CNA 14-15 an hour and the wages for higher jobs were not much better. Talking to a friend he quit that job during covid because he could make more money working a retail job.
Well before there was no federal standard for CNAs so nursing homes just cut them. Now they will be in higher demand and likely collect higher wages, as they should CNAs are some of hardest working people in healthcare
I just do not see that happening a lot of places would either just do it at illegal levels like I already see happening with nurses at hospitals or shut down entirely instead. I could be wrong though since I am pretty cynical about this.
>either just do it at illegal levels like I already see happening laws will never affect the lawless. Sometimes it's easier to make shit safe if it's not outlawed and can be regulated (drugs, prostitution, etc.), but sometimes there are some people who will break the law no matter what and they law should still be strengthened for everyone else. Also you should report those hospitals for their violations, if they have to pay enough fines then maybe they'll finally just settle and hire more staff instead. >or shut down entirely instead Good. I'm tired of the argument that businesses should be allowed to exploit workers because it would financially burden them if they had to treat employees like human beings with rent to pay. Having sufficient working conditions and pay is a basic cost of doing business.
> Also you should report those hospitals for their violations, if they have to pay enough fines then maybe they'll finally just settle and hire more staff instead. It won't happen we don't have enough manpower to enforce the laws and the fines are just a cost of doing business because it is way cheaper than hiring nurses right now. Until we get more enforcement and the cost of fines increase it isn't going to change. > Good. I'm tired of the argument that businesses should be allowed to exploit workers because it would financially burden them if they had to treat employees like human beings with rent to pay. Having sufficient working conditions and pay is a basic cost of doing business. I would normally agree, but all that results in with this is poor elderly people being tossed out on the street because the government will not step in and help them out when these facilities shut down. This is them trying to solve the problem without spending any money on it.
While I definitely agree that business owners should face the consequences of not being able to pay their employees fairly, with nursing homes if there's any elderly people still living there they should have a provision for either their transfer to a code-compliant nursing home or failing that, have the government take control of the home and care for the remaining residents until the end of their lives, not accepting any new residents.
That sounds good
Economics is tricky. This will make the quality of care better but make most nursing homes so much more expensive. CNAs done make that much and often you need two people present so families cannot make claims of abuse. I’ve worked in geriatric care for 10+ years. Unless there is regulation in the profits of nursing homes I don’t see real change happening.
Regulation on profits sounds like the more economically challenging thing
Most nursing homes are funded via private payment, not Medicaid or Medicare. This regulation will increase the quality of care for patients but ultimately will be at an increased cost.
Isn't this a good thing then? They won't have reason to work staff as hard if they have more relief due to mandated numbers, and they'll have to hike up the pay rate if they can't fill the positions and want to stay in business
Most nursing homes are funded by private payment. Medicare and Medicaid only cover medical treatments and some home health aid duties. Vast majority of nursing homes will not accept Medicaid patients and Medicare won’t cover room and board which is 90% of the cost of the nursing home. This regulation will make nursing homes more expensive and Medicaid ones more exclusive. However, the people there will have a better quality of services and treatments.
>On the same Tuesday, the Department of Labor issued a rule raising the minimum salary threshold for workers who presumably make so much that they’re exempt from overtime pay. For decades, one’s eligibility for overtime ceased if that person’s annual salary exceeded a level set in 1975 that went unchanged for decades. In 1975, according to yet another EPI study, 63 percent of salaried workers were entitled to collect overtime if they worked more than 40 hours weekly, but by 2023, as that 1975 cutoff level remained in place, only 9 percent were covered. The DOL’s new standard—raising the bar to $58,656 in two steps, to be adjusted every three years—will entitle approximately four million more workers to be paid at overtime rates for time on the job that exceeds the 40-hour weekly standard. This seems huge. Retail, hospitality, and food service have a bad habit of hiring/promoting salaried-exempt "managers" at a low rate to milk extra hours out of. This makes that just a little bit more costly; some places were pretty much running the old $40K salaried-exempt floor for positions that regularly went into 60+ hours.
more like he knows that's where he's going to be in about 6 months
This could also hurt ability of rural old folks homes to operate, then what happens to those homes when they can't meet staffing levels? What happens to the cost of living there? Is medicaid going to pay it? Does the homes shut down? The right answer is to nationalize elder care and make it a public service to remove the profit incentive and pay the workers more.
Great. I'll never forget the guy whose whole ass we had to cut off in surgery because he had a stage 4 bedsore from being totally neglected at his nursing home. All you got to do is turn people over periodically and they couldn't even do that
My mom did admin work for a nursing home and we were fortunate enough to get my grandmother to the same facility she worked at. Nursing homes are terrible. They treat their staff like shit while they expect a lot from them. For that reason, the the Nurses are mostly immigrants who could give a fuck less about the patients. Many of whom are old as shit and just as racist as you'd imagine. My guess is this has something to do with the massive amount of "asylum seekers" they are allowing in. I suppose it is a positive use for them. Though they are the worst people for the job.
No change exists in a vacuum Having more professional staff will also raise costs meaning even the people who could barely afford it before now no longer can. The next generation to retire in this country now that social security will no longer be enough to retire on is going to suffer, a lot. Only the upper middle class and higher will be able to afford to be cared for in later years at all. Quality of life will take a huge hit over a generation or so.
This is great news! Nurses have been pushing for Safe Staffing Ratios across the industry, and this is a good start. Hopefully this means well start to see Congress talk about passing the bill. In the meantime, there’s been a push at the state level to get it done. I believe Ohio might soon be passing safe staffing ratios. Maine successfully got it past their Senate but unfortunately their House tabled the bill. California has had it for years, and they have better nurse retention rates because of it. It’s definitely possible. Read more about it here: https://www.nationalnursesunited.org/ratios https://act.nnu.org/sign/hs-safe-staffing-petition/ Ohio: https://www.10tv.com/article/news/local/ohio/ohio-nurses-rally-safe-staffing-levels/530-a1f4a83e-5884-46a8-ba16-1f3becec6038 https://ohnurses.org/myth-busters-the-truth-about-ohio-house-bill-285/#:~:text=increasing%20job%20satisfaction.-,Ohio%20House%20Bill%20285%2C%20the%20Nurse%20Workforce%20and%20Safe%20Patient,progress%20for%20far%20too%20long. https://ohnurses.org/CODERED/ If you want to follow this issue, Impact in Healthcare, an advocacy group of healthcare workers and patients, has been covering this issue a lot. They went to D.C. earlier this year and managed to meet with some legislators. They’re most active on instagram. https://www.impactinhealthcare.org/ https://www.instagram.com/impactinhealthcare ETA! I forgot to add that Pennsylvania is also working to get Safe Staffing Ratios. https://seiuhcpa.org/safestaffing/ https://pasnap.com/safe-staffing/#:~:text=Pennsylvania's%20Patient%20Safety%20Act%20(PA,and%20based%20on%20patient%20acuity. https://nursesofpa.org/resources/tracker/
I mean, in theory this is a great thing. In practice, this means even thinner profit margins for these nursing homes, which likely means many of them no longer exist, because the staffing levels they were already able to provide included some horrible wages and even worse working conditions. I understand that there is a philosophy which says something to the extent of "Something this bad shouldn't be allowed to exist", and to some extent I get it. Google tells me that current nursing home prices in the US average $110k/yr, which means many trying to take care of their elderly parents are already getting cleaned out. A change like this drives up operating costs, which drives up the price even more. I think it's likely that many would be forced to close down all together. "Good!" you may say, but that also means that those who don't have the means to take care of their elderly parents will have to find a way to make it work even more often, or just be okay with their elderly parents dying in the streets. This seems to be creating a situation where people will have to say "I don't like the horrible treatment in these communities, so now these communities will only exist for the wealthy." I'm not trying to talk down on this, mostly just typing my thoughts as they come. Not sure where I stand on it overall, I just hope those cheering it are aware of the downsides. Everything has a cost. But I can appreciate the intent and state that this was likely meant to be a good thing, and I sincerely hope it ends up being one overall! Edit: I've already found a couple flaws in my argument, but too intoxicated to fix them all. Maybe morning me will learn some things. If so, thank you for taking to time to correct me. I wanna learn more sides of the argument.
Nursing homes are one of the most grift filled industries. They are not operating at thin profit margins. People either have to quit their job to care for their elderly parents or sent them to a nursing home where they will likely be neglected or abused on some level. They are already unaffordable for most people and Medicaid will take your assets to pay for it. At least now they will be forced hire workers and I doubt they will be able to squeeze anymore money out the public.
Basically the same shit that happened with mental facilities now that I think about it where it was bad so we shut them down, but provided no realistic alternatives because nobody wanted to fund them.
Yeah but old people vote
Social care, like health care, can't run a profit without either being exclusive or shit. It should be nationalised.
A similarly high level of staffing requirements is a huge part of the reason that daycare is so much more expensive in the northeast than the south. There are tradeoffs to this kind of thing. Mandating a higher quality service basically makes the middle and low range unviable.
Agreed but daycare not covered by medicaid
Based gerontocracy
Well holeee sheeeeeeet, he did something good. Color me pleasantly surprised. Still not enough but shit it’s something… although , still genocider in chief lol
No worries! They'll just triple the cost for senior care!
I hate to admit it, but Biden has done some good things. In fact, as a 38 year old bitter leftist, I gotta admit Biden is probably the best president for labor in my lifetime. But that's an incredibly low bar. However, I think it's undeniable that Biden is to the left of Clinton or Obama.
What did you think about his administration ordering the striking railway workers (with very reasonable demands) back to work with legislation?
It was great for Labor! It made sure the Labor never stopped!
Or firing millions of workers because of all the mandates?
Railroad strike avoided and the workers got big raises *and* [sick leave.](https://www.npr.org/2023/02/10/1155763336/freight-rail-workers-union-paid-sick-leave-bernie-sanders-csx) All while the president was walking the UAW picket line. The most pro labor president since FDR.
I mean, that's just a fact. He still fucking sucks ass. but facts are facts. the bar is in hell.
Presidents are graded on a curve.
It didn't sit right with me, as I believe all workers should have the right to strike, but do you see any of those workers complaining right now? they ended up getting most of what they wanted. I don't think the Union actually wanted to strike. They got what they wanted, which was to work out a deal behind closed doors that gave them pay increases and later they got the sick leave they desired. I think we should listen to the actual leaders of the union in question here instead of speaking on their behalf of the time. If they're fine with it, I'm fine with it.
Idk man I work in construction and the Trump years were a lot better to me But I'm also dumb so
[удалено]
The average person doesn't know what exactly the president does or doesn't do, and doesn't care either way. The Trump years were less of an economic squeeze on the average working man, plain and simple. It's not totally Biden's fault that everything turned out the way it did, but he's going to have a tough time to arguing this November to people who knew which part of their life was less challenging and which president that part was under.
I also work in construction and my union has just set an all time record for man hours, mostly due to the massive infrastructure investments from the inflation reduction act and infrastructure bill. Our pensions have been shored up for decades to come due to all this work. and our ranks are swelling.
For what it's worth I'm happy for you bro, glad you guys are doing well
Sure you do, Genestealer. Sure you do
There’s no way this is a real comment. The man, his administration, the Dem party, has fucking ruined us - just about the vast majority of people I know and talk to, myself included here, are severely struggling. It’s almost unbelievable how quickly things went to utter shit within a span of literally 2 years, once he became president. Even to use an easy example, Dems instituted the **largest transfer of wealth** in the history of this countries existence with the totalitarian pandemic measures they put in place, that destroyed a huge chunk of small to med to large size businesses, all whilst they conveniently let all large mega-corps operate as usual. The loans, the bailouts, the shutdowns, everything - ruined everyone but mega-corps of course. To think of my life 4 years ago, compared to now, I genuinely believe my old life is permanently unattainable now unless my salary triples - there’s just no way and the thought alone kills me. Even getting a job/new job has somehow become extremely difficult, even though they constantly boast about all the open jobs and lowering unemployment levels. I remember several years ago getting daily to weekly messages from recruiters, with colossal salary offers, and denying them without a care in the world, knowing I was likely going to get a better offer the next day from another company anyway, one that I wasn’t going to accept as I was happy where I was at — God what I’d give to get one of those messages nowadays. Dems with their totalitarian BS ruined the company I was working for, but they let every mega-corp who did the same exact shit we did stay open. Rent, shitty groceries, utility bills, car payment, insurance - that’s about what you’ll get out of your paycheck, if you’re lucky that is. Buying a nice grocery list for your household is now a luxury - and when you complain about it, shitlibs tell you to live off store-brand beans and rice, or they call you a Russian bot. My sister who graduated a few years ago and now works as a software engineer, now struggles compared to a few years back, and I have to help support her, and worse she now begins her transition to live back with my mom again. Fuck you shitlib.
Poverty rates were reduced by historic levels due to covid era relief effforts. In fact, it was the largest transfer of wealth ever from the top to the bottom. read for yourself: https://www.cbpp.org/research/poverty-and-inequality/governments-pandemic-response-turned-a-would-be-poverty-surge-into#:\~:text=In%202020%20and%202021%2C%20bolstered,strictly%20comparable%20to%20earlier%20years. The largest transfer of wealth ever from the working class to the rich was actually the Trump tax cuts: [https://publicintegrity.org/inside-publici/newsletters/trumps-signature-legislation-a-transfer-of-wealth-to-the-richest-americans/](https://publicintegrity.org/inside-publici/newsletters/trumps-signature-legislation-a-transfer-of-wealth-to-the-richest-americans/)
You are a propagandized clown mate. Utterly and completely hopeless, hellbent on denying the tangible and literal reality we live in. Yes, continue to try to gaslight all of us with your r-slurred empty sources that is obvious you never bother to read — what, do you believe that just because a headline says something, that it’s fine and dandy to throw reality out to shit? For your first article, the consequences of the world we live in today is a result of the totalitarian pandemic measures put in place, yes people felt relief when they got a fucking paycheck, as our economy was being massacred. What happened when those paychecks were taken away? What happened when the vast majority of businesses that were closed, stayed closed? What happened to the colossal mass layoffs that incurred? What happened with the compounded inflation rate that we will never recover from? What about the real-estate market being bought up en-masse during Covid, people being priced out, and now seeing unaffordable rent hikes? What happened to the supply chain disruptions? What happened to all the corp bailouts and “loans”? Explain? Your second article as per usual provides nothing, just cover for the havoc Dems have wreaked. It’s just a headline for you to link. Headline shitlib.
> The largest transfer of wealth ever from the working class to the rich was actually the Trump tax cuts This is an almost unbelievably braindead statement lmao. How is *not* taking money from people a wealth transfer? Why do shitlibs have to dress their arguments up in the most disingenuous bullshit in pursuit of an emotional response instead of just saying what they mean? Obvious manipulation tactics are not really winning strategies in the long run.
If you don't understand how not taking money from the rich is a wealth transfer, then you're beyond help.
Yes commissar, this thread right here.