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Nursing Assistants in Nursing Homes: Low Wages Despite Physically and Emotionally Demanding Work

PHI National, an organization focused on the direct care workforce, released its annual report on the current landscape of the work place for direct care employees such as nursing assistants. Before providing their most recent findings, PHI National opens with this statement: “The poor quality of nursing assistant jobs makes it difficult for nursing homes to attract and retain enough workers to meet demand.” Why are nursing assistant jobs in nursing homes considered so difficult to fill and why is it so hard to keep good employees? The biggest factors go hand in hand. Nursing assistant wages in nursing homes are notoriously low. PHI National reveals that the national average is $11.87 an hour. The work of taking care of residents with a myriad of complex mental and physical diagnoses is both physically and emotionally demanding, so much so that the average nursing assistant is 3.5 times more likely to be injured on the job than other American workers. When you pile endless responsibilities onto the plate of someone making less than $12 an hour, it should come as no surprise that you have a profession filled with overwhelmed, overworked, and emotionally drained employees. This is when mistakes are made and accidents happen. This is when the elderly are neglected, abused, left alone for hours, left in bathtubs overnight, fall while trying to use the bathroom, wander without being stopped, are giving the wrong medication, and develop pressure sores.

Chronic Understaffing Causing Employee Burnout and Resident Abuse and Neglect
Before we address the findings from PHI National’s recent report, we must address the driving force behind the trend in high patient to nursing assistant ratios. To put it bluntly, the cause is greed. The majority of nursing homes in the U.S. are privately owned, many by equity groups who view them as investments. The tragic heat-related deaths we recently witnessed at the Hollywood, FL nursing home after Hurricane Irma finally showed the world that money and profits are valued more than the health and safety of the elderly. In fact, it was only after the death of 8 residents from the Rehabilitation Center at Hollywood Hills that several other south Florida nursing homes without air conditioning began moving residents.

To those of us who fight for justice for the elderly, we know that many nursing home owners and administrators deliberately understaff their facilities in order to save as much money as possible. Because nursing assistants make up the largest percentage of staff at nursing homes, cutting back on the number of nursing assistants they employ can translate into large savings. The PHI National report revealed that 37% of staff members on a nursing home’s payroll are nursing assistants. They also spend the most time with residents, helping with most daily tasks and activities, such as bathing, meals, and moving from room-to-room, from a chair, their bed, and to/from anywhere else. In short, nursing assistants are constantly in demand. When low pay is coupled with caring for the constant needs of residents and not enough nursing assistants to share the work, it’s a recipe for an extremely unhappy, overwhelmed workforce that is putting our loved ones at risk.

Nursing Assistants in Nursing Homes: Major Findings
Taken directly from PHI National’s annual report, here are several key items about nursing assistants who work in nursing homes:

  • Nursing assistants earn a median hourly wage of $11.87, and a median annual income of $19,000.

  • Wages for nursing assistants have not kept up with inflation over the past 10 years: inflation-adjusted wages remained relatively stagnant, decreasing from $12.22 in 2005 to $11.87 in 2015.
  • Because poverty rates are high among nursing assistants, nearly 40 percent rely on some form of public assistance.

  • More than 9 in 10 nursing assistants are women.
  • Nursing assistants spend more time than any other nursing staff assisting residents, providing a median of 2.4 hours of hands-on care per resident per day.
  • In 2012, 47,300 open nursing assistant positions at nursing homes went unfilled, more than double the number of vacancies for registered nurses and licensed professional nurses combined. The high number of vacancies was due in part to 52 percent turnover among nursing assistants during the same year.

Fair Wages for Fair Work
The profession has to change. Placing our loved ones’ lives into the hands of those who are asked to do too much for too little is a sobering reality. Until nursing homes choose to pay fair wages for fair work, it is unlikely that those who enter the nursing assistant profession with the best of intentions can provide the quality of care that our loved ones deserve.

Nursing assistants in nursing homes are frequently placed in situations in which they feel their job and livelihood are in jeopardy. Being asked by management to take part in a coverup, to stay quiet about safety incidents or any other situation that feels morally wrong may be a violation of the Illinois Nursing Home Care Act. For over 25 years, the nursing home abuse and neglect attorneys of Levin & Perconti have worked with nursing assistants on reports of violations of this act, as well as to protect them from retaliatory action by the nursing home that employs them.

If you feel that spoken or unspoken practices or past incidents are in violation of the Illinois Nursing Home Care Act, please contact our Illinois nursing home whistleblower hotline at 312.332.2872 to find out how we can help you.