They really used their noodles for this one.

The government ends up footing the bill. The way the system works right now is that you're actually encouraged to go completely broke paying for care and at that point you can qualify for government coverage.

I think from an outside perspective that might be how it appears but in many cases these companies default to operating with skeleton crews because it means better profits. Let's take an example of one wing of a nursing home with 26 residents on it. You can ball park gross revenue for the nursing home for that wing at about 260k per month. Only around 1400 of that will be spent on nursing staff for the residents per day. IN A NURSING HOME, and that expenditure assumes they're paying their staff decently.

There are two issues at play. One, many of these facilities have been bought up by large chains that tend to have the strategy of sucking as much funding out of resident services as possible to maximize profit, and two the laughably inadequate government funding for long term care. If they are going to mandate staffing ratios it's going to require turning shitty jobs into good ones and that is going to mean providing better wages and conditions for everyone. Many of these places are staffing their nurses at 25+ patients and their cna's at 15 or more. It doesn't take a fucking genius to do the math here. A nurse on a 12 hour shift with 25 patients has a grand total of 27.5 minutes to dedicate to each of their patients. That's all in, meds, charting, phone calls, etc. So let's figure at best 10 minutes of charting per patient. Now we're at 17 minutes for meds and any coordination and care a patient might need. That is fucking absurd. A CNA on an 8 with 15 has 30 minutes to spend with each resident. That means incontinence care, turning, feeding, toileting answering call lights etc. Again it's fucking absurd. Read the reviews of almost any nursing home and youre gonna see comments that say something along the lines of "the staff doesn't care" Well that's because they literally don't have time to care. So the federal government needs to hurry the fuck up with making some standards because everyday they burn doing nothing represents more nurses and cna's who are saying fuck this and finding other jobs.