Should nursing homes be required to have more aides? Legislation says yes

Susan K. Livio, NJ Advance Media for

TRENTON — In a move intended to improve the treatment and safety inside New Jersey's nursing homes, a state Assembly panel Monday approved a bill that would set minimum staffing standards for certified nursing assistants.

The bill targets the professionals on whom residents rely the most to meet their basic needs — from eating, bathing, dressing and administering medications.

Nursing homes would have to require one nursing assistant be on duty for every eight residents on the day shift, for every 10 on the late day shift, and one for every 16 residents on the overnight shift. 

The Assembly Human Services Committee voted 4-2 to pass the bill despite the objections of nursing home operators, who argued quotas would interfere with daily managerial decisions they make based on the specific medical and emotional needs of residents.

Industry officials said passing a law won't change the fact that assistants or "CNA's" are in short supply in New Jersey and nationally. 

Jessica Pellegrino-Tsoukalas, the director for business development at Bridgeway Senior Healthcare in Somerset County, said they sponsor workers from foreign countries, help pay housing costs for some employees, and even have opened a vocational school to train employees.

"Even with these efforts, it's still not enough. We are forced to hire nurses to do the same work, and that is not factored into this legislation," Pellegrino-Tsoukalas said. "I know this bill is not going to help our patients."

According to the U.S. Bureau of Labor Statistics, there were 1.4 million certified nursing assistants nationwide whose median salary was $25,000 last year, although some made as little as $18,790. 

Generally, a nursing aide is required to have 75 hours of training. 

Annual turnover in the field is among the highest in any industry - exceeding 100 percent in some years because the work is difficult and pay isn't competitive,according to a 2004 report by the U.S. Department of Health and Human Services. 

The report said 1.2 million more nursing assistants would be needed to keep up for the demand for care as the baby boomer population ages.

Assemblyman Joseph Lagana, (D-Bergen), one of the bill's sponsors, said a survey of nursing homes in New Jersey found 40 percent would meet these staffing standards today. Another 25 percent of nursing homes would only be required to one to two more nursing assistants to meet the quotas.

"Mandating specific certified nursing assistant-to-resident ratios will create more precise, enforceable standards," said Lagana. "Ultimately, this will raise the bar for the standard of care throughout nursing homes in New Jersey."

An analysis of the bill by the New Jersey Hospital Association found nursing homes would collectively need to spend $67 million on nursing assistants to comply with the law, said Tyla Housman, deputy director for policy and government relations.

Paulette Johnson, a former certified nursing assistant who is now a nurse, urged the committee to pass the bill because she has seen how patients suffer staffing is short.

"There is no time for casual exchange of thoughts or words of good cheer. They are fed in a hurry, taken to the bathroom in a hurry, and even put to bed in a hurry," said Johnson a member of the union, SEIU 1199. "They either get depressed, get combative or refuse to eat or sleep."

Human Services Committee Chairman Valerie Vainieri Huttle (D-Bergen), one of the bill's sponsors, agreed.

"Countless studies have shown that higher staffing levels result in higher quality of care in nursing homes," Huttle said. "This leads to lower mortality rates, improved functioning, less infections, lower hospitalization rates and an overall improvement in quality of life, which is what we all want for our loved ones."