Then private-equity firms might have less incentive to enter this field, and patients and workers would know, once and for all, whether businesses are telling the truth when they say they’re operating on “a razor-thin margin.”
To improve residents’ quality of life, the government should mandate that long-term-care facilities have appropriate staffing. We can do this by requiring a minimum amount of nursing time for every resident — 4.1 hours per day, experts say. A bill to this effect was introduced in Congress in 2019.
And certified nursing assistants must be paid a living wage — in most places, $20 or more per hour. A recent study found that such an increase would finance itself by elevating the standard of care. With stable, better-paying jobs, nursing-home staff members could also avoid working in multiple facilities, helping reduce the transmission of the coronavirus and other, future viruses.
In addition, Mr. Biden must reverse Mr. Trump’s laissez-faire approach to this sector. Both C.M.S. and the Occupational Safety and Health Administration should be given the resources they need to inspect, investigate and fine providers for health and workplace violations. The incoming administration must also strengthen workers’ rights to organize and protest unsafe conditions under the National Labor Relations Act, as it has already promised to do.
Most important, we must transform the way we think about long-term care — treating it not as human warehousing or the duty of underpaid women, but as an integral part of our medical system.
All of these changes are possible — and modest, really, given the magnitude of the emergency. By 2050, 19 million people will be 85 or older, and many will require help to live with comfort and a modicum of dignity. What we really need, for all Americans, is single-payer health insurance that covers quality long-term care. But short of that, Mr. Biden and Kamala Harris have a chance to make amends for the deadly failures of the current administration.
Just before Christmas, I checked in with Danielle, the licensed practical nurse in Pennsylvania. She had a rare day off, which meant a reprieve from her oppressive uniform of N95 respirator, goggles, face shield, gown and shoe coverings. “Everybody in the facility has it,” she said. And now patients who had been treated for the virus in the hospital were being discharged straight into her nursing home to quarantine.