How Ohio became the No. 1 state for nursing home assistant shortages

 

This story is from the Investigative Reporting Workshop in collaboration with Eye on Ohio, the nonprofit, nonpartisan Ohio Center for Journalism. Please join Eye on Ohio’s free mailing list or follow IRW on Facebook as this helps us provide more public service reporting. Ohio nursing homes reported more shortages of nursing assistants than any other state during the pandemic, highlighting a problem that has been festering for decades. 

An Eye on Ohio and Investigative Reporting Workshop analysis of weekly reported data from the Centers for Medicare and Medicaid Services found that Ohio reported the the highest number of shortages in the country for State Tested Nursing Assistants (STNA) in 2020 and through the first half of 2021, leaving critical care positions open and shifting work to other positions suffering shortages of their own.     

Ohio has the third highest number of nursing homes behind Texas and California, and tallied STNA shortages in 26% of reports to the Centers for Medicare and Medicaid services (CMS). That makes Ohio the 14th worst nationwide for the percentage of nursing homes reporting too few STNAs that same year. “We just have probably the worst shortage that we've had at least in my 35 years of doing this,” said Robert Applebaum, director of the Ohio Long-Term Care Research Project at Miami University’s Scripps Gerontology Center.

SIDE BAR: The long road for nursing home legislation in the Statehouse

This story is from the Investigative Reporting Workshop in collaboration with Eye on Ohio, the nonprofit, nonpartisan Ohio Center for Journalism. Please join Eye on Ohio’s  free mailing list as this helps us provide more public service reporting. As Ohio grapples with the highest number of State Tested Nursing Assistant (STNAs) shortages in the country and decades-long issues of pay and work conditions, legislation over nursing homes has become a lucrative battleground both nationally and in the state. 

The industry’s primary trade group representing two-thirds of nursing homes has spent more than $30 million on lobbying to Congress since 2010. The state affiliate, Ohio Health Care Association (OHCA), and its related entities have contributed millions of dollars in recent years to political groups that have supported various campaigns, including Gov. Mike DeWine’s. 

Unlike other states, Ohio legislators — not the state’s department of Medicaid — determine the funding formula for nursing homes. Federal legislation from 1987 mandated only that nursing homes provide “sufficient staffing” of nursing assistants.

Covid Correctional: behind Ohio’s campaign to get prisoners vaccinated

When James Burris was sent to quarantine in a solitary confinement cell, the doctor wouldn’t tell him who allegedly exposed him to the coronavirus, citing laws protecting personal medical information. Burris said he and the four other men sent off to quarantine with him deduced who might have exposed them by comparing notes. 

“None of us knew each other,” Burris says. “The only thing we had in common was we all had been in [remote] contact with the Global Tel Link lady.”

Global Tel Link, or GTL, provides digital tablets inmates can use to buy music and rent movies. Burris’ signed up to see the GTL worker because his tablet was broken, but he said he hadn’t even met with her that day because he had been in dialysis. No one in the quarantine group caught COVID-19.

No Comprendo Covid: Pandemic reveals lack of bilingual health workers

In the early months of the pandemic, Cleveland Councilwoman Jasmin Santana, who represents a West Side ward with the densest population of Latinos in the city, said health department officials reassured her that when the city released urgent health updates, they would be translated into Spanish. 

It didn’t happen. 

The city put out public releases, sometimes daily, as the pandemic evolved – about safety precautions, work restrictions, and how many people were infected with the virus – but the information didn’t seem to make its way to the Spanish-speaking residents in Santana’s ward, where close to 40% of residents are Hispanic. 

When she pressed again, this time with city communications officials, Santana said she was told the city didn’t have resources for translation. 

One high-ranking city official suggested Santana and her office should create Spanish-language versions to distribute, she said. 

The reaction startled her. 

“I almost didn’t know how to respond,” Santana said. “That's when I started really realizing, ‘You know what? This is a huge issue for the city.’ Who would have thought that a city with more than 300,000 residents wouldn’t be ready to have their communications translated?” 

(A city spokesperson did respond to questions about what Santana was told.)

Santana’s concerns as a councilwoman were rooted in what she’d witnessed growing up in her community and later as a health outreach worker: that language and trust act as barriers to resources that can improve or save lives. The COVID-19 pandemic has intensified pressure on a chronically underfunded public health system that already faced staggering disparities in access to medical care and health outcomes, especially for people with limited English proficiency. 

But the crisis also has offered an opportunity, which some local health departments have embraced, to forge relationships and connections that could outlast the virus. 

Cleveland, a city that declared racism a public health crisis almost a year ago, with officials vowing to tackle disparities and inequities, has seen some progress but it has been sluggish. 

Despite a windfall in pandemic aid, Cleveland still has not beefed up its own contract tracing operations by adding bilingual staff. Instead, it has relied on the state health department for virtual assistance with Spanish-speaking residents and a language translation line.

Fighting to open closed doors: how advocates stepped up efforts to help sex trafficking survivors in a world where hiding victims is easier than ever

This article is from Eye on Ohio, the nonprofit, nonpartisan Ohio Center for Journalism. Please join their free mailing list, as this helps provide more public service reporting. For women survivors of sex trafficking struggling to make ends meet, the COVID-19 pandemic has exacerbated an already desperate situation. Funding programs to support them have shifted to more urgent crisis funding— to house and feed the homeless, for example. Losing financial and food security only places these already scuffling women at an even greater risk of being trafficked again to earn money just to survive.

This Speech Clinic (Literally) Helps Trans People Find Their Voice

This article provided by Eye on Ohio, the nonprofit, nonpartisan Ohio Center for Journalism in partnership with the Buckeye Flame. Please join our free mailing list or the mailing list for the Flame as this helps us provide more public service reporting. After beginning with some vocal stretches to warm up her voicebox, Ginger Williams hums and vocalizes to match a tone played by Maureen Brogan, a student clinician. “Good! I got 195,” Maureen reports. 

“Yes!” Ginger whispers, her excitement quiet but palpable even over video conference. Her 195 signifies “195 hertz,” which falls nicely into the 180-240 range associated with a female pitch. 

For Ginger, a transgender woman, this result is exactly what she is here to achieve.

Ohio Department of Job and Family Services tries to bolster its own workforce by posting jobs with no medical benefits in pandemic

This article is from Eye on Ohio, the nonprofit, nonpartisan Ohio Center for Journalism. Please join their free mailing list, as this helps provide more public service reporting. Amid a raging pandemic, Ohio’s agency responsible for looking out for workers’ welfare has started posting full-time temporary jobs with no benefits for its own workforce. 

For example, this week the Ohio Department of Job and Family Services (ODJFS) sought to hire an “electronic design specialist,” a job that requires a bachelor’s degree, years of experience, or some combination of both. The hours listed are full time, with a schedule that is “not negotiable” and the position is “not eligible” for benefits.  

As total COVID-19 cases in the state soared to nearly 600,000 and deaths rose to almost 8,000, Eye on Ohio asked why the positions are listed without medical benefits when large employers have to give most of their workforce— even temporary workers— medical insurance eventually under the Affordable Care Act, or pay a penalty. 

A spokesman for ODJFS said “Benefit eligibility under the ACA for temporary or part-time positions is determined based on the length of time employed and hours worked during that period of time.” 

Eye on Ohio further inquired if the positions have a set end date and why officials listed positions with no health care as the chances of getting a debilitating disease have risen. Officials did not respond to multiple requests to comment. 

Each job posting begins with, “The Ohio Department of Job and Family Services’ mission is to improve the well-being of Ohio's workforce and families by promoting economic self-sufficiency and ensuring the safety of Ohio's most vulnerable citizens.”

But it’s not clear if ODJFS’ own workers could be self-sufficient with its own positions: according to Heatlhcare.gov, a monthly premium for a nonsmoking family of four in Columbus is approximately $810. That’s about 24% of what an ODJFS electronic design would make after taxes.