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COVID 19 and Skilled Nursing Facilities: When Deregulation
is Deadly
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FOR IMMEDIATE RELEASE
April 15, 2020
In
response to the coronavirus pandemic, the federal agency than runs the
nation’s Medicare program has waived longstanding resident protections
and promised more money to nursing facilities. Congress has already
increased payments to facilities and promises more. A crisis brings out
the best in many people, including health care providers, both
professional and paraprofessional, who literally put their lives on the
line every day to take care of the sickest and frailest among us. But in
others, a crisis brings out the worst. For these, the pandemic gives them
virtually free reign to operate, with even fewer rules, fewer
inspections, fewer staff, and fewer relatives visiting.
Forty-seven
people died in the outbreak in a Kirkland, Washington nursing home, the
first known “hot spot” in the U.S. Fourteen deaths were recently reported
in a New Jersey facility. So far, coronavirus cases have been identified
in thousands of nursing homes across the U.S. and there are likely many
more infections occurring behind closed doors. Some states are reporting
that more than half of their facilities have residents infected with
coronavirus. We may never know because the CDC has announced that it is
not keeping track of deaths in these facilities.
Most
of the health care provided in these homes is funded by Medicare and
Medicaid. Until recently, facilities choosing to be eligible for federal
payments have been required to meet federal standards of care and have
been monitored and rated for quality. Not all these facilities were
providing high quality care before these recent changes. Far from it. And
in fact, infection control is the number one problem occurring in nursing
homes nationwide, with nearly two out of three facilities cited for
problems in their infection control and prevention practices. Last
summer, Medicare regulators proposed easing rules that required infection
control personnel to be in every facility. So now instead of stepping up
oversight in the face of this pandemic – one that disproportionately
kills medically fragile older people – rules are being relaxed and
waivers are being granted that make it easier for nursing homes to skimp
on service and make things more precarious for vulnerable residents.
Nursing
homes across the country are going on “lock down,” blocking visitation of
residents by caring family members. In some nursing homes, family members
often show up to feed and help perform and oversee the daily routines
their relatives need. What happens now to those frail elderly people who
lose these family caregivers, especially when chronically short-staffed
facilities have even fewer staff during the pandemic?
Finally,
nursing homes believe they have been given the right by the government to
transfer patients at will – requiring no consultation from family or
residents themselves. They will be able to shift residents into newly
created facilities that will separate those testing positive with
Covid-19 from the rest of the population. A big question remains whether
these newly opened facilities will merely segregate and hold people with
the disease or provide real care.Advocates
are calling for another bill that will fill some of the gaps in service
for the 1.3-1.4 million vulnerable Americans who live in nursing
facilities. Any bill must meet these three requirements:
- First, accurate and meaningful information
about which nursing facilities have residents and staff with
confirmed cases of coronavirus needs to be made public. The absence
of clear, comprehensive, and truthful information creates more fear
and anxiety for residents and families and the public in general.
- Second, tracking cases of the coronavirus in
nursing facilities is important so that essential resources – staff,
personal protective equipment – can be sent to those facilities with
the greatest need.
- Finally, government needs to take
responsibility to make sure that all facilities – newly created
facilities and existing facilities – have the tests, staff,
supplies, food, and equipment that they need.
Join Us Live This Week and
Next for Updates on COVID-19 and Nursing Homes
Join
us for a pair of joint Webinars from the Center for Medicare Advocacy,
Consumer Voice, Long Term Care Community Coalition & Justice in
Aging:
This
two-part examination of some of the major issues impacting nursing home
residents right now at the national and state levels will begin with an
overview and discussion about the changing landscape of federal actions,
as well as advocacy that our collective organizations have been engaged
in with CMS and Congress. Part II will continue the look at issues
affecting residents and include example of State-level advocacy that are
currently underway to influence state action and protect residents.
The Center for Medicare
Advocacy (http://www.medicareadvocacy.org), established in 1986, is a national
nonprofit, nonpartisan law organization that provides education,
advocacy, analysis and legal assistance to help older people and people
with disabilities obtain fair access to Medicare and quality health care.
We focus on the needs of Medicare beneficiaries, people with chronic
conditions, and those in need of long-term care. The organization is
involved in writing, education, and advocacy of importance to Medicare
beneficiaries nationwide. The Center is headquartered in Connecticut and
Washington, DC, with offices throughout the country.
Center for Medicare Advocacy, Inc. • www.MedicareAdvocacy.org •
PO Box 350, Willimantic, CT 06226 • 1025 CT Ave. NW, Washington, DC 20036
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