Crisis at the Champaign County Nursing Home

THE CHAMPAIGN COUNTY NURSING HOME needs ten more
nurses. According to nursing home administrator Andrew
Buffenbarger, that’s what it would it would take to meet the
home’s need for 30 nurses without resorting to high-priced,
high-turnover contract nurses. Along with a recent cut in
state Medicaid funding, the home’s reliance on contract nursing
to fill the staffing gap is the major factor contributing to
the home’s persistent operating deficit of about $1 million.
The deficit, down from $2 million after the County
Board hired an independent consulting company to find
ways to improve the home’s finances, has become a major
crisis for the board, which is struggling to find cuts to avoid
having to dip into county coffers. The county’s finance
committee has given the nursing home about a month and
a half before the home will need to absorb a cut of about
$500,000 of its $15 million budget. According to Buffenbarger,
that means not being able to pay the home’s bills.
The immediate healthcare needs of the 60% of residents
who depend on Medicaid now hinges on who blinks
first—the nursing home administration, or the board.
Why is the nursing home having such a hard time
finding and retaining full-time nurses? In part because,
like most other healthcare providers, it’s facing a national
nursing shortage. According to the Department of Health
and Human Services surveys, increased demand, an aging
population, and crowded nursing schools are contributing
to a growing number of unfilled nursing positions
throughout the U.S., as well as an escalating wage war
between healthcare providers competing for nurses. It’s a
wage war that public facilities can’t win. With lower
wages than comparable private facilities, the home has to
attract and retain nurses with a different incentive: an
intangible combination of benefits, good working conditions,
and morale that board members like Jenny Putman
refer to as “TLC.”
But as the nursing shortage worsens, full-time nurses
are facing deteriorating working conditions as they shoulder
higher workloads alongside employees who have been
hired to fulfill some of the roles that would otherwise fall
to nurses. A 2002 study published in the Journal of the
American Medical Association reported that 75% of working
nurses felt the nursing shortage was increasing stress
and leading to attrition.
This same finding was echoed at the County Board’s
April 15th study session by AFSCME Local 31 representatives,
who reported that full-time nurses at the Champaign
County Nursing home are having to divide time between
nursing and helping contract nurses learn about the home’s
policies and residents. Union representatives also reported
that morale was low and attrition was high because many
nurses were unhappy with their supervisors. But with no
formal exit interview process to shed light on why nurses
are leaving, and informal talks between workers and the
board largely stalled, time is running out to find out what
changes need to be made, much less make them.
In fact, the ticking clock has trumped most other concerns
for the board, and at the recent study session the
board came up with dozens of short-term measures, most of
which were aimed at reducing operating costs or raising
revenue in the very short term. From raising rates on singleoccupancy
rooms to renting out unused space, no single
measure appears capable of bridging the $1 million shortfall.
Given time and public support, filling the gap in the
home’s full-time nursing staff could go a long way towards
putting its finances on a sustainable course. But with just a
few weeks remaining before the cut, the public and the
board are going to have to either make a major, renewed
commitment to the nursing home or face the prospect of the
elderly poor and ill going without necessary care.