Rebecca Silva is always by her grandfather’s side, to keep him company and be a voice when he is not able to advocate for himself.

"It was hopeless. I was legitimately that day watching my grandfather die in front of my face," said Silva.

This past February, her 92-year-old grandfather was rushed to the hospital following a brief stay at Collar City Nursing and Rehabilitation Center. He was originally checked in for physical therapy for knee pain. But Rebecca says between unsanitary conditions, short staffing, and a lack of attention to care, she watched her grandfather’s condition decline rapidly.

"He's diabetic and he takes a bunch of medications per day. And I know that he has to have them at a certain time per day, and he hadn't had them yet," said Silva.

After two days at the facility, Silva noticed that her grandfather was unresponsive.

"I'm watching my grandfather die, and you still haven't called an ambulance. So I had to call it myself. I had to run and find a nurse to ask what I had to say, ask what medications he was on in order to get the ambulance there in time," said Silva.

He was diagnosed with chronic respiratory failure and an altered mental state. The medical report from St. Peter’s Hospital reads “A high probability of sudden, clinically significant, or life-threatening deterioration." The report also states that he was "essentially admitted because of a combination of over and under medication.”

Silva fears that if she hadn’t called the ambulance herself, her grandfather wouldn’t have made it.

"He actually had to be dosed with Narcan several times because he was being overdosed on medication that they prescribed him on opioids," said Silva.

Short staffing continues to be a concern for nursing homes across the state, as advocates for older New Yorkers call for more state funding. According to data from the New York State Office for the Aging, more than 5,000 complaints were filed between October 2021 to June 2022, and the agency says that number is on the rise.

The U.S. Senate Special Committee on Aging released a new report, titled "Uninspected and Neglected." The year-long investigation dug into the capacity of state survey agencies to oversee health and safety standards for the nation's 15,000 nursing homes. The report found that 31 states and the District of Columbia had inspection staff vacancy rates above 20% on average. New York’s vacancy rate was 59% — the fourth highest nationally.

Under the state's $229 billion budget, $2.5 million will go towards a program for overseeing and inspecting nursing homes and long-term care facilities.

"I've had clients come home with infections and things because of the neglect in the facilities, or they were going into a facility to be rehabbed to come home and never make it back home," said Kara Kozakewicz, a private care nurse.

Kozakewicz decided to become a private caretaker after hearing troubling stories from loved ones and colleagues.

"There's two major things, and it's our state policies right now and I think the financial aspect of it, and both insurance and facility-based pay, you know, could change why we're so struggling in this field," said Kozakewicz.

Kozakewicz hopes for significant changes in the industry, so that families don’t have to experience the fears of not having a loved one looked after.