An organizing campaign that is signing up underpaid and overworked caretakers. A legislative assault for safe staffing legislation. A publicity blitz painting facility operators as uncaring for the health of their patients.

Sounds like the campaign to organize nurses at Los Angeles area hospitals? Yes, but it's not.

It's the closely allied campaign being led by the Service Employees International Union against the region's nursing homes, nine of which the union has organized over the past 10 months, adding 800 workers to its area ranks.

And like the nurses debate, there is agreement on some fundamental problems, but a parting of ways on solutions.

The nursing home industry agrees that workers who feed, bathe and provide other basic care to patients are underpaid, making on average $10 or $7 an hour depending on who's doing the estimates. It also agrees there are not enough workers.

But just like the hospital debate, labor contends that strict staffing ratios and better working conditions will help attract workers, while the industry argues there simply aren't enough workers who want to fill the tough, emotionally demanding jobs.

The result has been a tough battle in Sacramento over a safe-staffing bill that appears headed for passage in the Legislature but only after being substantially watered down.

Labor had wanted to impose ratios requiring one certified nursing assistant (the primary care takers in nursing homes) for every five patients starting in 2004. Instead they had to settle for a bill that simply converted hard-to-enforce existing standards into ratio form and put them up for future reviews.

Those standards mandate patients receive 3.2 hours of care each day, and are the equivalent of requiring one nursing assistant for every seven workers, according to the legislation.

Labor called the compromise a partial success.

"Now any patient or family member can walk into a facility and say, 'Wait, you have 10 patients for every one worker,' and file a complaint," said Beth Capell, chief lobbyist for the union.

The industry claims it is doing the best it can with the money it has. "When you look at health care there is such a high standard, but the resources that are given do not equate," said Michael Torgan, vice president of customer service at Country Villa Health Services, a Marina del Rey operator of 28 facilities. "You would not expect the same level of service at McDonald's that you would expect at Spago."

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