Raising the minimum wage by as little as 10 percent would significantly improve the safety and health of nursing home residents, according to new research.
Most direct care in nursing homes is provided by nursing assistants, who make up about 40 percent of the nursing home workforce and are among the lowest-paid workers in the U.S. economy. Nursing assistants help residents with activities of daily living like eating, bathing and dressing, and and work with certified nurses and elder care teams to monitor patients’ conditions.
Due in part of their low wages, nursing assistants frequently change jobs for better pay or working conditions. “Between 60 percent and 85 percent of nursing assistants leave their employers each year, most often to go work in other nursing homes,” writes Krista Ruffini, a visiting scholar at the Minneapolis Federal Reserve. Nursing homes frequently report difficulty in recruiting and retaining staff, she says.
Ruffini recently looked at the impact increasing the minimum wage has on nursing home staff turnover and quality. She compared facilities in hundreds of U.S. counties that had increased their minimum wage with those that hadn’t between 1990 to 2017.
In findings based on her preliminary data published in a working paper, Ruffini found that “increasing the minimum wage by 10 percent would reduce the number of health inspection violations by 1 percent to 2 percent, the number of residents with moderate to severe pressure ulcers [bed sores] by about 1.7 percent, and the number of deaths by 3 percent.” The 3 percent reduction in deaths, she notes, translates to 15,000 fewer deaths in nursing homes each year.
Ruffini found that raising the minimum wage reduced turnover and increased tenure among nursing assistants. This greater continuity of care, she says, translated into improved health and safety conditions for the patients. At the same time, nursing home profits held steady because the extra costs were passed on in the form of higher fees.
Ruffini notes that her findings have particular relevance in a time when the coronavirus pandemic is overwhelming nursing homes. Comparing a facility’s number of COVID-19 deaths with its quality-of-care performance, she concluded: “The data provide some suggestive evidence that higher service quality is associated with fewer deaths from COVID-19 in nursing homes.”
“Everyone needs a will, but, increasingly, estate planners say people also could benefit from setting up a trust while they are alive. That step would help assure that their assets are distributed more quickly, their bills paid promptly and continuously and personal information about property and other assets are kept out of the public eye.”
You might think of a trust as something for wealthy people who want to dispose of high-end assets, like art work, collectible cars or businesses. However, just like everyone needs an estate plan regardless of their asset level, says The New York Times in the article, “Life After Death? Here’s Why You Should Have a Trust,” many people who are not wealthy could benefit from having a trust.
There are many different kinds of trusts which serve different purposes. One is a revocable trust, which the owner can change. They are considered by many to be the “work horse” of modern estate planning. A revocable trust can avoid the need for a public probate court proceeding after the person dies, saving time and keeping money from being immediately available to heirs and executors alike.
Trusts are also useful for times when people become incapacitated and need someone else to take care of their finances. Because many more people are living longer and the number of people with dementia is increasing, there are more situations where trusts are useful to the family and caregivers.
A will is different than a trust and is a public document. The probate process requires a disclosure of assets, bank and other financial accounts and the names of beneficiaries. That information remains private with a revocable trust.
Other considerations regarding trusts:
You should have any type of trust set up by an estate and trust attorney.
A house, real property, bank or investment accounts can be placed into a trust.
A revocable trust does not always end at the death of the original owner. How long it may last depends upon the laws of your state.
People also use trusts to protect their assets from others or to assure the long-term care of someone who is disabled.
You can have a professional manager, family member or friend as a trustee or co-trustee of a trust. Sometimes having a licensed professional who has federal reporting requirements can provide an extra layer of protection.
Speak with an estate planning attorney who can discuss the different types of trusts that are available and determine which one is best for your particular situation.