The Employee Rights of CNAs and Other Nursing Home Staff

With the U.S. population aging rapidly, the demand for senior care and for qualified caregivers has increased dramatically within the past decade. Certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs) each play an important role in the nursing home environment. Each of these types of caregivers has specific rights and responsibilities as employees of a nursing home or other long-term senior care facility. While nursing home insurance offers liability protection against a wide range of risks, nursing home managers and owners must have a keen understanding of their employees’ rights as a vital risk management tool. In this guide, we will explore some of the specific rights of CNAs and other employee classes in nursing homes.

The Employee Organizational Structure Within Nursing Home Facilities

In addition to managers and support staff, patient care in nursing homes is comprised of several job classifications. Typically, the patient care organization is made up of a Director of nursing or a nurse manager – usually a registered nurse (RN) or a nurse practitioner — who supervises a team of certified nursing assistants (CNAs) and licensed practical nurses (LPNs). Although CNAs and LPNs do not have the same level of medical training as RNs, they still perform a crucial role in patient care.

CNAs are often referred to as nurse aides or patient care assistants. Although commonly confused with the term “orderly”, CNAs have a different and more skilled role to play in nursing home environments. These employees are commonly tasked with patient assessments such as:

  • Obtaining vital signs
  • Moving and/or repositioning patients
  • Monitoring patient activities
  • Bathing and feeding patients
  • Assisting with medical procedures
  • Wound dressing
  • Answering patient calls
  • Documenting information about patients

Every state has its own regulations governing the duties and tasks performed by CNAs and LPNs. Facility managers must be keenly aware of these guidelines, helping to ensure that employees are not working outside of their scope of practice, and that their employee rights are upheld.

CNA Rights in Nursing Homes

According to figures compiled in 2018 by the Bureau of Labor Statistics, there were approximately 1.5 million CNAs employed in the United States. Over the next ten years, growth in this employee classification is expected to reach 9%; as the population ages, elderly care becomes increasingly important and staffing levels are expected to climb in relation to the number of elderly individuals.

As with most other employee classifications, CNAs have specific rights in the workplace. LPNs and RNs have similar rights. These rights include:

  • A safe work environment, particularly in regards to violence and hazards like repetitive motion or heavy-lifting injuries when handling or repositioning patients. Workplace violence plagues the healthcare field; in 2014, 52% of all reported workplace violence incidents involved employees in healthcare and social services.
  • A work environment that is free from harassment or discrimination from all stakeholders, including managers, fellow staff members, and nursing home residents and their family members.
  • The ability to report violent residents who may be physically, verbally, or sexually abusive.
  • Overtime pay for work beyond the standard 40-hour work week. The overtime rate is set by the Fair Labor Standards Act at 1.5 times the regular hourly pay rate.
  • The ability to appeal when or if the employee have abuse or neglect claims lodged against them.

Facility managers and owners obtain nursing home insurance to protect against a wide range of liability exposures. Violation of employee rights may not be covered, and the coverage amounts of these insurance policies may not be sufficient to protect facilities from expensive litigation and regulatory penalties if an employee’s right violation should occur.

Pushing for Enhanced Rights in the Healthcare Field

Despite a growing demand for qualified caregivers, many nursing homes struggle with adequate staffing levels, particularly among CNA and LPN classifications. As a result, there is a concern that these facilities may no longer be able to adequately care for residents, potentially leading to claims of neglect or negligence. Those nurses and paraprofessionals that have jobs in long-term care facilities may feel overwhelmed with high patient loads; intense work demands often lead to employee burnout, not to mention physical injuries.

To better protect nurses and CNAs, states across the country are adopting or exploring laws that mandate nurse-to-patient ratios. So far, California is the only state with a sweeping law of this nature, while other states have implemented the ratios for only some areas of healthcare, such as in intensive care units as well as in nursing homes and skilled care facilities. Regardless, these laws are designed to protect the rights of healthcare employees. With the coverage of nursing home insurance and new employee protection laws, nursing homes across the country will be able to provide competent and compassionate care for their residents, all while protecting the rights and safety of their most valuable assets – their employees.

About Caitlin Morgan

Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at 877.226.1027.