Maryland Needs to Enhance Nursing Home Regulations

August 25, 2017


By:  Commentary:  Andy Kum and Joy Phillips August 24, 2017 

Today’s nursing homes are far different than those of the past. Due to a rapidly changing health care delivery system and longer life spans, Marylanders from all walks of life rely on these facilities. 

As a licensed practical nurse and a geriatric nursing assistant, we take care of residents between the ages of 33 and 103. In addition to the “typical” scenario of someone’s parents or grandparents who need round-the-clock help, a resident may be someone’s son who is paralyzed from a motorcycle accident or someone’s older sibling who has a developmental disability and needs full-time care. 

We witness the lives of these residents up close. We work tirelessly to bathe them, lift and transport them, take them to the bathroom, give them their medicine, treat their wounds and change their feeding tubes. We also offer emotional support if they suffer from depression or memory loss or are simply lonely. 

You may be surprised to learn that, over the course of a seven-and-a-half to eight-hour shift, we each provide care to 15 to 25 residents. That means we have a very limited time to spend with each resident to perform bedside care such as administering medication and treatments, providing proper care to prevent pressure ulcers and deformities, and cleaning wounds and changing bandages. Would you want your loved one to receive only an hour or two of bedside care each day? 

There is a massive shortage of nursing staff in Maryland – and in our country – at a time when these roles are critically needed. Adding to the problem, Maryland regulations require just one nursing service person on duty per 25 residents. That’s simply not enough to give each resident the proper care and attention they need and deserve. 

In Maryland, nursing assistants earn a median hourly wage of $13.22, taking home so little that as many as 35 percent of workers rely on public assistance such as food stamps or Medicaid. We are on our feet most of the day and the job is physically grueling. As a result of low pay, insufficient staffing levels and high injury rates, nursing home employers are struggling to retain qualified nursing assistants. 

Adding to the problem, nursing homes self-report their staffing levels and other data. As The New York Times reported in the August 2014, facilities hire staff before annual inspections and cut them days afterward, effectively manipulating the Medicare ratings system to save money. 

Better standards 

One solution? The health care industry needs better regulation to address the quality of care and staffing crisis in Maryland’s nursing homes. 

To respond to this issue, last fall, our health care union, 1199SEIU United Healthcare Workers East, advocated for strengthened state regulations to ensure better standards of quality care. The regulations would increase the hours of bedside care and the number of nursing service personnel per resident. 

These regulatory updates were the result of a lengthy stakeholder process begun by the Maryland Department of Health in September 2014. Now, the department needs Gov. Larry Hogan’s concurrence to go forward. Unfortunately, he has not responded. For nearly 365 days, the state has denied nursing home residents better, more compassionate care. 

With more staff on duty, we would have time to actually listen to our patients. We would be more likely to notice if something was wrong or bothering our patients.  We could offer more proactive care and do more to prevent hospital transfers for unrecognized illnesses or falls. And keep in mind that a hospital transfer for these often fragile patients is not a small thing; it can mean the end of their life. 

Whether a parent, grandparent, son, daughter, sister or brother, these patients each have their own unique story. They all deserve to be treated with dignity and humanity. Please call on Hogan to endorse these regulations before this crisis touches someone you know and love. We need better regulation to protect those who cannot protect themselves. 

Andy Kum is a licensed practical nurse in Howard County. Joy Phillips is a geriatric nursing assistant in Baltimore City. Both are members of 1199SEIU United Healthcare Workers East, Maryland’s largest health care union. Kum can be reached at  

Take Action Today!

Call Governor Hogan today at (410) 974-3901 and urge him to endorse these regulations (COMAR 10.07.02 – Comprehensive Care Facilities and Extended Care Facilities) before this crisis touches someone you know and love.