- The Washington Times - Thursday, August 23, 2001

A group of Marylanders is seeking to improve nursing home care by encouraging potential gubernatorial candidates to hire more care providers.
The group "6 to 1" seeks to establish a 6-to-1 patient-to-staff ratio in Maryland nursing homes, which currently have about a 12-to-1 ratio, according to the Mid-Atlantic Non-Profit Health and Housing Association.
"The current situation is an absolute disgrace," said Ralph Jaffe, 60, a retired high school teacher who heads the group.
Citing his own experiences in visiting and volunteering in nursing homes over the past 16 years, Mr. Jaffe said he has found that patients, who are mostly helpless, get little supervision in their rooms, where they spend the most time, often lying for too long in their own waste.
"It seems we as a society have an obligation to do better," he said.
To that end, his group's volunteers have asked the presumed front-runner in the 2002 gubernatorial race — Lt. Gov. Kathleen Kennedy Townsend, a Democrat — to join them in urging nursing homes to adopt a 6-1 patient-staff ratio.
Mr. Jaffe said the lieutenant governor has balked at pressing nursing home operators, even though about 430 volunteers who back the effort have called her office.
Mrs. Townsend's office referred questions to the state's Department of Aging.
A top aide to U.S. Rep. Robert L. Ehrlich Jr., Maryland Republican and a potential gubernatorial candidate, said the congressman is aware of the chronic staffing shortages in Maryland's nursing homes.
"There's no doubt in my mind he'd look hard at it [if he enters the governor's race]," said Ehrlich aide Paul Schurick. "Health care in Maryland has reached a crisis point, and reimbursement rates to the providers have to be increased. The bureaucracy that regulates the system has to be overhauled or it cannot survive."
No one has officially announced a candidacy for the governor's race, which will be decided next year.
Increasing nursing home staffing "is really a budget decision that needs to be made by the governor's and lieutenant governor's office," said Stephanie Garrity, chief of client and community services for the Department of Aging.
"Any kind of increase at all is going to take budget work," Ms. Garrity said, adding that state and federal funds pay the costs for many residents who rely on Medicaid to afford nursing care.
Adam Kane, public-policy director for the Mid-Atlantic Non-Profit Health and Housing Association, noted that the 6-1 ratio sought by the group is about half the current ratio.
"We'd love to have a 6-to-1 ratio, but the state would have to commit enormous amounts of resources, and we can't create people [to fill the jobs]," Mr. Kane said, adding that turnover rates among nursing home aides average about 100 percent annually.
Nursing homes are required to provide patients two hours of care daily, and Maryland homes have reported an average of more than three hours. But it is not clear how much time reported as care is spent on administrative tasks and how much is spent on patient assistance.
Maryland has about 30,000 patients in 261 nursing homes, 233 of which were recently evaluated for the first time by the state on the occurrence of falls and fractures, bedsores, dehydration, depression and other health risks. The state's report, released this month, classifies the homes in broad categories, placing them in the top 20 percent, middle 70 percent or bottom 10 percent for each factor.
The report was commissioned by the General Assembly to address concern about the quality and availability of nursing home care; provide information about the age, sex, ethnicity and debilitation level of patients; and show how often restraints and medication are used to manage patients.


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