On Sept. 28, completely avoidable circumstances could cause a lot of stress and heartache for more than 150 residents at the Vermont Veterans Home in Bennington.
That's the deadline for home management to remedy multiple violations that caused Vermont's Division of Licensing and Protection -- a government agency that enforces federal standards -- to cite the home and threaten to pull $12 million in federal funding that comes to the home from the Centers for Medicare and Medicaid Services. To give you an idea of the sense of urgency the home management has attached to the violations, one of them occurred in May 2012 and it has still not been addressed as I write this.
Caring for the Vermont veterans who literally call the facility home are more than 200 nurses, caregivers and other dedicated employees, most of whom have worked at the home more than five years. Like the veterans, the caregivers are equally concerned about the looming possibility of the home losing its federal money and certification -- and possibly even closing.
The state has already warned that the money may not be there to continue operating the home if the federal money goes away (the state did continue to fund the Vermont State Hospital after it lost CMS money and certification). If the state can't -- or won't -- make up the difference, nearly two-thirds of the home's current resident population will almost immediately be displaced and forced to move to unfamiliar new locations (some out of state even) and be in the care of what initially will be strangers.
The caregivers say it shouldn't have come to this and they want to assure Vermonters -- especially those with family members at the home -- that they are doing everything in their power to work with management to fix the problems that have led to this potential crisis, prior to Sept. 28 deadline. But it's been frustrating.
As one caregiver recently wrote to Governor Shumlin: "[Employees] have for several months been trying to get management, administration and [the home] governing board to listen to us and address these issues before they destroy our wonderful nursing home. Unfortunately, we received nothing but constant runaround, blame shifting and outright dismissal of the importance of the situation."
For months, even years, the home caregivers and their union, the VSEA, have been trying to sound an alarm about the toll chronic short-staffing and mandatory overtime are taking on the facility's work force. In fact, some the home nurses, caregivers and other employees rearranged their busy schedules to participate in a July "Put Patients First" public forum in Bennington to educate concerned citizens and legislators about the home staffing crisis.
The home management's ongoing response to employee concerns has been promises and pledges, yet the problems persist and all of the unfortunate incidents that are currently jeopardizing the home's funding and certification remain. In each of the incidents documented by Licensing and Protection, caregivers say short staffing is the root cause for the events that occurred. In two incidents, licensed caregivers were so busy with other veterans that the home management turned a blind eye and assigned certain specialized work to caregivers not licensed to perform the jobs they were being ordered to do. In the other incident, staffing was so short that no caregiver was available to assist a resident in need.
The home management argues that what caregivers call "staffing" issues are really only "scheduling" problems, but it's not a fair characterization. While it's true the home management can often show the required number of caregivers being present at the facility "on paper," VSEA caregivers argue that the larger issue is with how those caregivers present are being utilized and directed by their superiors.
When VSEA asked the president of the Vermont Federation of Nurses and Health Professionals to look at the home staffing issues, she reported back: "What I have seen/heard of the home staffing situation and management's description of how they are addressing it, appears to be inadequate all the way around. Moving staff around in a schedule with many holes is what we refer to as "squeezing the balloon. It doesn't address the root cause which is not enough staff."
The home caregivers and VSEA stand ready (as they have all along) to work with the home board of trustees and the home management over the next week to avert a potential disaster for hundreds of Vermont veterans and their family members.
In many ways, these veterans are like family to the people who provide their daily care, and these caregivers know the negative impact this potential upheaval will have on their residents. The problems at the home are in no way insurmountable, but in order for things to begin to get better, caregivers believe there must first be an acknowledgment by the home management that a staffing issue does exist and that it will be fixed. Vermont's veterans deserve nothing less.
John Reese is president of the Vermont State Employees Association.