Advocates call for laws to increase staffing, improve care at nursing homes

Advocates are calling on state lawmakers to enact changes that will improve conditions and care for residents at long-term care facilities, including Carver Living Center, that has been the focus of multiple WRAL investigations in recent weeks.

The state currently does not have laws dictating a certain nurse-to-patient ratio, nor does it have state laws outlining how many hours per day each nurse should spend with residents. That’s a problem for Bill Lamb, who serves on the North Carolina Senior Tar Heel Legislature, a group that lobbies the general assembly on issues related to senior citizens.

“North Carolina should not be proud of our standard,” Lamb said. “We lag behind most of the states in the United States. And that’s a problem as we look at the aging of our population.”

It’s also a problem to the family of Leon Garrett, who spent about five years in Carver Living Center before passing away over the summer.

They say Garrett was unable to care for himself, and yet Carver Living Center staff were not helping him with even basic necessities like eating and drinking.

“This man is bed bound,” Garrett’s sister, Princess Rhodes, told WRAL Investigates. “He can’t take care of himself. He can’t talk. And I feel that facility took advantage of that, and they left him alone.”

“You don’t hope for people to lose their job, but that facility needs to be shut down,” Garrett’s niece, Alexis Green said.

Green and Rhodes said a key issue was there were never enough nurses on site.

“When you go in, it’s a ghost town,” Green said.

WRAL has reported that the nursing home on East Carver Street has been cited multiple times by state inspectors, and has been fined more than $200,000 in the last three years.

Most recently, WRAL reported on an employee at the facility being convicted of assaulting a resident, after the resident’s family caught a disturbing incident on camera.

Neither the facility nor its ownership company, CCH Healthcare, has responded to WRAL Investigates despite weeks of attempts to reach them by phone, email and in person.

Medicare.gov shows the time residents at Carver get with nurses is worse than the national average – 3 hours and 38 minutes per resident per day, versus the national average of 3 hours and 48 minutes per day. And the nursing staff turnover is much worse (65% versus 49%).

In 2025, one of the top priorities for the Senior Tar Heel Legislature is pressing for a law that dictates a certain number of hours that staff must spend with each patient each day in assisted living facilities.

Lamb explained that new federal rules just went into effect over the summer, requiring residents get about three and a half hours a day with nursing staff. He says many states have their own laws that go above the federal minimum, but North Carolina does not have any law on the books. Similarly, it does not have a set standard for a nurse-to-patient ratio.

“The quality of care in nursing homes is a direct result of the quantity, quality and stability of the direct care workforce,” Lamb said. “Having a defined standard gets at least some assurances that there is an adequate number of staff available. And the standard we’re looking at really is a minimum standard.”

WRAL Investigates spoke with Rep. Donny Lambeth, a Republican representing Forsyth County, who chairs the Health Committee.

“I haven’t looked at the patient ratio in a while,” he said. “I will look at it.”

“The ratios,” he continued, “will, you know, add to the cost. If you lower the ratios, [it] will add to the cost. And right now is a tough time to get more federal money, more state money.”

Lambeth noted that the root of the issue lies in the finances, and not having enough healthcare professionals.

“The nursing industry, the long-term care industry is in serious trouble,” he said. “Pay is a big issue … they’re going to other positions and making a few dollars more … We were able to put a significant amount of the COVID money in during the COVID period in terms of like bonuses that helped a lot with retention. But that money has all been spent and gone away.”

Lambeth said the state tends to use federal regulations in this area and not enact more restrictive rules at the state level.

“We haven’t spent a lot of time [on this] as legislators,” he said. “We’ve deferred most of that to the HHS Department. But I think it’s time for us to step up and do a little bit more investigations and get some data and determine if we need to make some changes in that industry.”