AARP, in an article published in December 2020 that is entitled, “Who’s to Blame for the 100,000 COVID Dead in Long-Term Care?” stated, “The single greatest error of America’s response to the pandemic in nursing homes, most agree, was the failure to provide early and vast access to virus testing for residents and staff. Without testing, nursing home staff focused on isolating residents who showed symptoms of the virus, while asymptomatic residents and staff continued to spread the virus throughout the facilities.”
“CMS finally required nursing homes to test residents and staff in September. By then, the damage had been done. Even at that late date, some nursing homes were still experiencing test shortages and in some cases could not receive lab test results within a week.” “The entire testing process in this country has been a complete debacle.”
“In the early days of the outbreak, nursing homes were caught flat-footed, without N95 masks and other needed equipment. A federal policy of prioritizing critical care hospitals left states to procure their supplies. That set off bidding wars and often left nursing homes empty-handed.”
“In March, CMS made what many consider another huge mistake by suspending routine state inspection of nursing homes and restricting long-term care ombudsmen, who are charged with advocating for residents, from making visits. The rules were meant to prevent outsiders from bringing the virus in. But as a result, nursing homes operated without scrutiny.” “We really don’t have a good picture of what’s happening.”
“By September, nursing homes had received over $21 billion in federal relief funds, according to CMS. But only $2.5 billion was specifically allotted to infection control; the rest came with almost no strings.” “It’s in my hall of shame that the federal government gave the nursing homes those dollars with no accountability.”
“The nursing home industry has been aggressive in shifting the blame and in trying to avoid the financial consequences of the deaths in its facilities. This summer, Mark Parkinson, AHCA’s president, announced a $15 million media campaign to boost public opinion of nursing homes, which was badly bruised by the pandemic. The association is also pushing for state and federal immunity from legal liability during the outbreak, which has been granted in more than 20 states.
But data is beginning to show linkages between nursing home quality and coronavirus cases. For example, researchers at both the University of California, San Francisco, and the University of Rochester Medical Center found that facilities that had received lower quality ratings from regulators before the pandemic were more likely to suffer outbreaks.
Seventy percent of nursing homes are for-profit operations, a factor that’s been linked to the spread of COVID-19. An August report commissioned by Connecticut found that for-profit homes in the state had about 60 percent more COVID-19 cases and deaths per licensed bed than nonprofit facilities.
Risks may be even worse at for-profits run by private-equity firms, which acquire nursing homes, cut costs and then sell at a profit. A study by Americans for Financial Reform Education Fund found those nursing homes in New Jersey had a disproportionate share of COVID-19 deaths.
Staffing levels also appear to be a key factor in the virus’ spread. In August, a study in JAMA found that across eight states, facilities with higher levels of nursing staff had fewer COVID cases than those with fewer staff.
And in July, a report published by the National Bureau of Economic Research raised alarms about the common practice of care staff working in multiple facilities. Nursing homes with higher rates of shared staffing, the researchers found, had higher rates of infection. Limiting care staff to a single nursing home, they concluded, could reduce COVID-19 infections in facilities by 44 percent.”
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