staffing

Montana’s care homes struggle with staffing and ever-changing regulations as COVID-19 cases rise | State & Regional

During the first three months of the pandemic, Coe kept a bed in his office because he didn’t want to infect his family and wanted to reassure his staff he was there for them.

“Health care and our industry didn’t bring this to the state, but we’re living with choices everybody makes whether you gown up, mask up, you wash your hands — whatever happens, if it gets into the facility, we have to live with whatever happens,” Coe said.

‘Staff doesn’t grow on trees’

The Montana Health Care Association serves long-term care facilities in the state, and many have reached out to get answers and support, according to Rose Hughes, the association’s executive director.

“To me it has just brought forth a whole new experience and lots of questions about how should these things be handled,” Hughes said in an interview in September. “What can you do? Because staff doesn’t grow on trees and facilities have trouble hiring staff as it is.”

Hughes said that several assisted living facilities have reached out for help.

She said the association has asked DPHHS multiple times for written guidance for assisted living facilities.

“Usually the response was, well, they need to follow CDC guidance,” she said. But, trying to navigate the CDC website for answers can be daunting.

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Nursing homes in Washington state struggled with adequate staffing for years. Then coronavirus struck.

In early March, state inspectors entered a sprawling nursing home in the rural southeast corner of King County where concerns over thin staffing were mounting just as COVID-19 began to spread across the state.

One resident inside the Enumclaw Health and Rehabilitation Center said she hadn’t been bathed for nearly three weeks after she first arrived, according to inspection records. Another described waiting roughly 15 minutes for help after her roommate fell on the floor, while others told of even longer waits for help, lasting 45 minutes or more.

“Sometimes there are so few people in the building,” the resident told inspectors, “if there were an emergency, it would be a calamity.”

Within weeks, coronavirus entered the nursing home, and workers scrambled to help ailing residents, as some got sick themselves. In all, the outbreak killed 26 people, according to the state.

As COVID-19 devastated nursing homes across the state, long-standing staffing woes created a perfect storm at many facilities at a time when workers were needed most. Even though inspectors had routinely found appalling instances of time-strapped staff and patient suffering over the years, Washington state hadn’t raised its standard for adequate staffing.

A Seattle Times analysis found that inspectors cited 118, or more than half, of the state’s skilled nursing facilities a total of 225 times for having insufficient or unqualified staff, according to federal data from 2018 through the start of the pandemic. The state rarely penalized nursing homes for these deficiencies, according to an analysis of thousands of pages of enforcement documents.

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In dozens of interviews and a review of inspection reports, workers described poor wages

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