To the editor:

The staff shortage in nursing homes is critical now, and more so in the future. Many comments assume that those who run nursing homes have the resources to pay staff significantly more. Some assume that if administration didn’t have such “outrageous” costs, staff could be paid more. Some main points are not recognized.

1. Nursing homes are reimbursed by Medicaid at less than any reasonable cost of care. Political support for Medicaid in general and for nursing homes is suspect at best. Given all the needs of public expenditure, support for nursing homes does not exist. Even elderly advocacy groups will fight strongly against Medicare cost reductions, strongly against Social Security cuts and for reduction in drug costs that affect all elderly. Yet such political support does not exist for the smaller percentage of older people who need nursing home care. When asked why support doesn’t exist at the state or federal level, I was once told at a senator’s office that “you have no constituency”!

2. In our society, sickness, dependency, etc., are obviously not desired. Given the many needs for public funds — e.g., education, defense, infrastructure, etc. — support for nursing homes don’t even come close to support for home care, which is what would definitely be a high priority compared to institutional care. One recent study asked people in general if support exists for frail elderly; the response was 90%. Yet when all areas supported by the government are listed, the support for the long-term care for the elderly was suspect at best.

3. Medicare only covers a small percentage of those needing long-term care. It only covers skilled or rehabilitative services. Many are surprised to find this out when care is needed.

4. The overall political will for support for nursing homes is as follows: The thought of being in a nursing home terrifies people in general. Avoidance of such a possibility results in minimal resources to function at a high level in future. Demographics for future care giving are scary.

5. There are abuses noted throughout the country. Blaming the vast majority of nursing homes as the problem is misguided. Blaming the victim for the lack of public support is wrong.

6. Those who work under difficult circumstances are to be recognized for attempting to provide quality care. Anyone who worked in a facility or had a loved one in a facility appreciate the reality of dedicated workers!

William O’Reilly

Saranac Inn