What to Do About Protections for Nursing Home Residents During the COVID-19 Pandemic

What to Do About Protections for Nursing Home Residents During the COVID-19 Pandemic

Coronavirus continues to decimate nursing homes, as residents make up more than 40% of California’s COVID-19-related deaths. Yet despite this, nursing homes continue to operate with significantly less oversight than before the virus outbreak occurred. To minimize risk and the virus’ spread, state inspectors have stopped annual inspections, family members are prohibited from visiting, and complaint investigators, such as Ombudsman, have stopped entering facilities. California Health Advocates joins advocates cross the nation in our concern for the safety and wellbeing of nursing home residents. Halting and barring all such inspections and visitors cuts a vulnerable population off from those who protect them at a dangerous time, a problem already exacerbated in nursing homes with track records of poor care.

Tony Chicotel, a staff attorney for California Advocates for Nursing Home Reform, sums it up by saying, “I can’t think of any other time like this, where all of the layers of oversight are missing. My guess is there’s lots of terrible neglect going on that is harming people to levels that are akin to the virus, but we just don’t know.”

To address this situation, mid June the House Select Subcommittee held a hearing on “The Devastating Impact of The Coronavirus Crisis in America’s Nursing Homes.” They heard from health experts, advocates and impacted Americans who all agreed that shortages in testing, PPE, and staff have led to thousands of deaths. Unified guidance from the federal government and oversight on how nursing home management and staff must care for and keep residents safe is of ongoing critical importance and high concern. Below are the key points and recommendations our partners’ at Justice in Aging provided at the hearing. Read the full testimony of Eric Carlson, Directing Attorney, for details regarding each recommendation.

  • Many nursing facilities operate with longstanding problems that have had lethal consequences during the COVID-19 pandemic.
  • The federal government should prioritize personal protective equipment (PPE) and COVID-19 testing for nursing facilities.
  • Congress and/or the Centers for Medicare and Medicaid Services (CMS) should set standards for nursing facilities that are dedicated to the care of COVID-positive residents, and for the transfers of residents to and from such facilities.
  • Congress or CMS should require facilities to employ a full-time infection preventionist with broad expertise.
  • Given the disparate impact of COVID-19 on people of color, CMS and the Centers for Disease Control and Prevention (CDC) should require facilities to include ethnicity in COVID-19 reporting.
  • CMS should require facilities to submit staffing data, in compliance with federal law, so that Congress, CMS, and others can understand how facilities have been staffed during the emergency period.
  • CMS should emphasize that “compassionate care situations” are not limited to end-of-life circumstances, so that nursing facility residents are not indefinitely isolated from family members and friends.
  • CMS should re-establish meaningful standards for nurse aide training.
  • CMS should require state survey agencies to address complaints filed during the emergency period and resume comprehensive onsite surveys.
  • Congress should consider bold changes to our nation’s system for providing long-term assistance to older Americans and persons with disabilities.

This week, as a result of this hearing, the Committee has already launched an investigation of CMS and five nursing home chains. CMS’ lax policies and oversight during the pandemic and the Trump Administration’s failure to provide testing, supplies and PPE to nursing homes may well have contributed to the high mortality in nursing homes. The Committee sent letters to the five nursing home chains that provide care for over 80,000 people in 40 states, hundreds of whom have died. The letter demands information about “coronavirus cases and deaths, testing, personal protective equipment, staffing levels and pay, legal violations, and efforts to prevent further infections” as well as information about “the use of federal funds by nursing homes during the pandemic.”

More resources on nursing home rights and updates during COVID-19:

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Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.