By Steve Moran

In response to COVID-19 and the disastrous impact it has had on nursing homes, the president established an independent body called the Coronavirus Commission on Safety and Quality in Nursing Homes. One of the members of the commission was Lori Porter the CEO of the National Association of Health Care Assistants.  

She is a CNA and a passionate advocate for CNAs. As such and a member of the commission, she went on record as supporting the findings and recommendations coming out of the commission. Although she had reservations about two recommendations relative to staffing. She felt they did not go far enough to protect frontline workers.

Lori Porter

Lori loved telling me how cool it was for her, a high school drop-out, to be on this panel of 25 government leaders and well-educated experts with MDs and PhDs from elite schools. The other really cool thing: this is very likely the first time a CNA has gotten to the White House.

To Endorse or Not Endorse?

It was not an easy decision to fully endorse the report or endorse it with reservations. Ultimately Lori endorsed it with reservations because not enough is being done to resolve the problem of adequate staffing and adequate staffing pay. The two issues are tightly coupled.

Here is a bit of what the problem looks like:

Three nights ago I was on a video call with 50 CNs and there wasn’t a single CNA on that call . . . [they] reported taking care of no fewer than 22 people on their own. I can’t provide person-centered care to 22 residents. I can’t, it’s impossible.

Solving the Staffing Problem

While we have primarily blamed COVID-19 deaths and infection rates on lack of testing and PPE (and they clearly did contribute to the problem), there is strong evidence that nursing homes with higher staffing levels have consistently fared better than buildings with lower staffing levels. Lori says the problem “can’t be solved overnight.”

In Lori’s view there are two critical factors that could transform nursing homes:

  1. We need to give CNAs what they want, and most leadership does not have a clue what that is. More than anything else, CNAs need to be included, to be seen as a critical part of the care team. They spend more time with residents than anyone else. And they know residents better than the nurses, and way better than the doctors.

    They are significantly more important than doctors who only see residents once a month while CNAs see them every single day.
  2. The current national average for CNA pay is $13.00 an hour, which is a pretty remarkable number since it means a lot of CN’s are making less than that. She is calling for an immediate increase that would raise that average to $16.00. And, on top of that performance pay, as CNAs invest in themselves to add certifications and skills.

Here is one of the things that so many leaders miss. Only 6% of CNAs want to be nurses. Most actually like and take great pride in being CNAs. The big challenge is whether or not we will as an industry, as a nation, give them the respect they deserve. And demonstrate that respect with pay and a place at the table. 

You must watch the whole interview here: