LAS VEGAS -- Ambiguous state laws are raising questions about how many staffers are needed to adequately care for nursing home residents. Patient advocates say the low numbers are causing neglect in local facilities.
A recent report rates Nevada nursing homes as some of the worst in the country. State inspectors cited every single Nevada facility for deficiencies, including actual harm to residents.
One of the issues appears to be a lack of workers inside nursing homes. Nevada, and most other states, do not have clear regulations on how many residents are too many to oversee. Nursing homes are able to determine how many workers are enough.
In all 48 of Nevada nursing homes, problems were uncovered by state inspectors. One Henderson facility is on a federal watch list. Inspectors say other homes have neglected patients to the point they had physical injuries.
A caregiver at one facility, who asks to go by the name Rachel because she doesn't want to face repercussions for speaking out, talks about the problem.
"Understaffed, underpaid, and overworked," she said.
She covers the overnight shift and is sometimes required to handle as many as 10 residents at once.
"You can't be constantly working, worried about this one falling, when you've got all these other people to take care of," she said.
Rachel's paycheck shows she makes around $10 an hour as a caregiver. Trained certified nursing assistants only make about 50 cents more.
"Half the time, these companies ought to realize, you get what you pay for, like in anything."
Inspection reports show staffing issues facing the facilities. In one report, a resident prone to wandering got out and went to a casino. When state inspectors interviewed workers later, they said "we just did not have enough time to do the 15 minute checks."
In another report, a woman in a wheelchair fell down stairs and hurt her back. State reports show "no one was with her."
Advocate and former ombudsman Brian Lee says staffing issues could be leading to neglect.
"The staff stretched too thin, couldn't supervise, couldn't watch the resident," said Brian Lee with Families for Better Care.
8 News NOW asked the Department of Health and Human Services if staffing is a problem. They responded by the following email, "Inspect nursing homes each year to determine regulation compliance along with staffing plan adherence."
The state health office, along with the Nevada Health Care Association, the trade association for nursing homes, both dispute the findings of the recent nursing home report. They say the current nursing shortage makes it hard for facilities to find qualified workers, but there is no shortage of actual workers in the buildings themselves. Rachel says her experience leads her to one conclusion on how to handle the decline of loved ones.
"Keep them at home."
She says the best way to care for a loved one is to arrange one-on-one care.
Because the state laws are unclear, no one has been able to tell 8 News NOW exactly how many staffers should be with a resident at any given time. The Nevada Health Care Association says some facilities have ratios as low as 3-to-1, while others are higher.