New staffing law, old struggles bedevil California nursing homes

Gabby Carrillo, a certified nursing assistant, serves a patient a meal at the Californian-Pasadena, a nursing home in Pasadena. A new state law will require that patients receive a minimum number of hours per day from CNAs, but homes fear they won't meet the requirement. (Maria Alejandra Cardona / Los Angeles Times)

 The 93-year-old dementia patient was getting anxious in her wheelchair.

The woman, a resident of the Californian-Pasadena nursing home, wanted to see her husband but had forgotten he was at a nearby hospital.

Holding the chair steady was a composed Gabby Carrillo, a certified nursing assistant who had witnessed this behavior before.

“We try to see things in their shoes,” said Carrillo, a CNA for more than three years. “Doing this job can be exhausting, not just physically but mentally too. Over time, you learn to cope with it.”

Despite the challenges, the 27-year-old professes a love for her job, which involves bathing, feeding and attending to other daily needs of patients. But the stressful work — coupled with low wages and a booming economy — has made it more difficult than ever for nursing homes to fill the position.

Now, state legislation that went into effect July 1 is putting even more pressure on the state’s 1,000-plus nursing homes, which some in the industry say could be forced to turn away or even discharge patients as a result.

The law, championed by organized labor and patient advocates, tightened staffing requirements for direct caregivers and added new ones specifically for certified nursing assistants.

Carrillo assists several patients at the Californian-Pasadena nursing home. (Maria Alejandra Cardona / Los Angeles Times)

The Service Employees International Union, which pushed for the law and represents nursing assistants, acknowledges that nursing homes face a challenge, but said there is an overriding health-and-safety issue.

“There must be enough direct care staff to meet the quality care needs of nursing home residents and ensure a healthy workload for every caregiver,” said an SEIU local representative who declined to be identified.

Quality-of-care concerns have long plagued nursing homes and are well documented, most recently in a May report by California State Auditor Elaine Howle.

The report dinged the California Department of Public Health for its oversight of nursing homes. And it found a one-third increase from 2006 to 2015 in violations of federal regulations that were likely to cause serious injuries or death.

“We are at rock bottom,” said Patricia McGinnis, director of California Advocates for Nursing Home Reform, a patient advocacy group. “I don’t ever want to go to a nursing home, and I don’t know anyone who would.

The new law requires facilities to provide 3.5 hours of direct patient care each day, up from 3.2 hours. But the primary worry for nursing home operators is a first-ever requirement that 2.4 of those hours must be filled by CNAs.

The department will begin enforcing the law July 1, 2019, and homes that fail state audits face penalties of $15,000 to $30,000.  (Click to Continue)

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New staffing law, old struggles bedevil California nursing homes