September 23,2020

Finance Committee Releases Report on Performance of Nursing Homes & Long-Term Care Facilities During the COVID-19 Pandemic

Washington Senate Finance Committee Chairman Chuck Grassley (R-Iowa) today released a comprehensive report on care in nursing homes and other long-term care facilities in the United States during the ongoing COVID-19 pandemic. The report, titled “COVID-19 and Nursing Homes: What Went Wrong and Next Steps,” reviews U.S. nursing home performance during the first eight months of the pandemic. Data indicate that more than two out of five deaths due to COVID-19 in the United States are linked to nursing homes and other long-term care facilities.
“Partisan finger pointing, rather than meaningful analysis, cannot serve as a useful guide for policymakers in crafting the necessary bipartisan reforms in response to the unprecedented challenges facing this entire sector and its employees working on the frontlines during this pandemic,” the committee report notes. “Any suggestion that coronavirus-related deaths in nursing facilities are attributable solely, or even primarily, to acts or omissions by the current administration falls well short of addressing the multi-faceted problems in this sector. Such a one-dimensional approach necessarily overlooks several factors that fueled the outbreak of COVID-19 in nursing homes across the United States, and around the world. Minimizing, or devoting scant attention to such factors, makes it enormously difficult for members of Congress to come together in support of long-overdue reforms and bipartisan solutions to the complex problems facing nursing homes today.”
The report examines what steps might have prevented these fatalities by minimizing the spread of COVID-19 and discusses what steps could be taken now to stem the tide of deaths in nursing homes during this and future pandemics.
Key findings of the report:
·      Private nursing homes have had widespread deficiencies in infection control and prevention for many years preceding the COVID-19 outbreak;
·      State governments and health officials in some hard-hit states fell short of their responsibility to ensure quality care, and in multiple states, staffing and supply shortages persisted for years prior to the pandemic;
·      State governments in some cases failed to enforce federal guidelines for these care facilities as required through their participation in Medicare and Medicaid, particularly guidance provided to minimize coronavirus transmission in their facilities;
·      Nursing home staff who work in multiple facilities unwittingly played a key role in COVID-19 transmission in nursing homes;
·      Nursing homes around the globe have struggled with many of the same issues as the United States during the pandemic, including Europe, the United Kingdom and Canada;
·      Several governors pressured nursing facilities to accept COVID-19 patients when personal protective equipment (PPE) was still in short supply and some did so even after the federal government made temporary hospitals available in their jurisdictions; and
·      The sector has received significant relief assistance from Congress and the Trump administration totaling approximately $21 billion in addition to technical assistance, guidance and training.
The report offers members of the committee additional background on the challenges that many nursing homes have faced, and continue to face, during this year’s public health emergency period. It makes specific recommendations for Congress, based on best practices that these facilities and some public officials adopted during the pandemic to protect nursing home residents and personnel. It includes additional recommendations to better protect the nation’s older Americans from elder abuse, neglect and exploitation. Many of these recommendations are embraced in legislation previously introduced by Grassley and other senators.
The full report can be viewed HERE. Appendices to the report containing information from the Federal Emergency Management Agency (FEMA) can be found HERE, HERE and HERE and from the Centers for Medicare and Medicaid Services (CMS) can be found HERE.
Grassley has long been a leader in the effort to protect older Americans, especially those living in nursing homes and other long-term care facilities. Since the outbreak of COVID-19, Grassley has helped lead congressional oversight of nursing homes and their response to the deadly pandemic.
In April, Grassley wrote to Department of Health and Human Services (HHS) Secretary Alex Azar and CMS Administrator Seema Verma regarding several issues related to the outbreak of COVID-19 at long-term care facilities such as nursing homes and assisted living facilities across the country. Grassley expressed concerns about testing capacity, inconsistencies in data tracking, a lack of PPE and transparency in federal spending. Following Grassley’s call on CMS to require nursing homes and other long-term care facilities to report all cases of COVID-19 to the federal government, the agency took such steps to ensure transparency and useable data.
In July, Grassley and Sens. Steve Daines (R-Mont.) and Martha McSally (R-Ariz.) introduced the Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020, which would improve existing programs to protect older Americans while also providing help to nursing homes in light of the COVID-19 pandemic that has posed serious problems for these facilities. The legislation includes several provisions to help nursing homes facing COVID-19 outbreaks, including the establishment of specialty regional “strike teams” that can rapidly respond to new outbreaks and extend COVID-19 related reporting requirements through the end of 2020. The bill calls on states receiving federal relief assistance to devote some funding to tele-visitation programs so nursing home residents aren’t isolated from family amid the stresses of the pandemic. It also renews and reauthorizes funding for several programs enacted in the Elder Justice Act of 2009 and boosts transparency and accountability measures for underperforming nursing homes.
Following the Trump administration’s announcement that it would require weekly testing of nursing home staffers and the disbursement of an additional $5 billion in funding to these facilities, Grassley praised the action as a big step in the right direction, which will help further protect the lives and health of both the residents of nursing facilities and the dedicated staff who care for them.
A Q&A with Grassley from April on COVID-19 and nursing homes can be found HERE.