Grassley, Daines, McSally Introduce Elder Justice Legislation to Boost Programs, Help Fight COVID in Nursing Homes
Washington – Senate Finance Committee Chairman Chuck Grassley
(R-Iowa) 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 will 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.
virus has taken a serious toll on older Americans and caregivers. The first
major outbreak of COVID-19 and a significant number of fatalities have occurred
in nursing homes. This bill will provide resources and ramp up accountability
to curb the spread and effects of the pandemic. It’ll also renew several
programs already in effect that protect seniors from abuse and neglect,” Grassley said. “I plan to work toward
this bill’s inclusion in any additional coronavirus relief legislation that may
“I’m grateful for the important work being done by
Montana’s nursing homes and assisted living facilities who care for and help
keep our most vulnerable populations safe,” Daines
said. “This bill is critical to
ensuring that our senior care facilities have the resources necessary to
continue serving and keeping Montana’s seniors safe especially during the
ongoing COVID-19 pandemic.”
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 televistation programs, so
nursing home residents aren’t isolated from family amid the stresses of the
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.
Emergency Support for Nursing Homes and Elder Justice Reform Act is endorsed by
the Elder Justice Coalition, National Adult Protective Services Association,
Alzheimer's Impact Movement and Alzheimer's Association.
of this bill follows last month’s World Elder Abuse
(June 15, 2020), which was established to highlight the widespread problems of
abuse, neglect and exploitation of seniors. Grassley’s resolution designating
June 15 as World Elder Abuse Awareness Day was unanimously
in the Senate.
also entered the following prepared statement into the Congressional Record.
Statement for the Record
Senator Chuck Grassley
Chairman, Senate Finance Committee
Introduction of the Emergency Support for
Nursing Homes and Elder Justice Reform Act Of 2020
July 2, 2020
today I am introducing legislation to better protect older Americans, a
population that’s suffered, more acutely than most, from the brutal impacts of
the COVID-19 pandemic.
This bill, on
which I’ve been working with my colleagues on both sides of the aisle for
several months, makes emergency relief available for personal protective
equipment, diagnostic testing, and strike teams for nursing homes in crisis
during this national emergency. There is broad agreement on the need to ensure
that these homes and assisted living facilities have the resources they need to
safely and effectively care for their elderly residents.
This is an area
in which I’ve worked for decades. My purpose for introducing the bill today is
twofold: first, I want to confirm that this issue, nursing home relief, is a
top priority for all Republicans, contrary to the statements by some of my
colleagues across the aisle yesterday. I’ve asked several of the Senators who
spoke on the floor yesterday, including Senator Casey, to work with me on a
bipartisan package in this area, and so of course I’m disappointed that they’ve
decided instead to pursue a partisan approach.
Second, my hope
is that version of this bill can be included in the next relief package our
chamber adopts. That’s why I’m circulating this proposal now, to give my
colleagues in this chamber an opportunity to contribute input. I want to thank
Senators Daines and McSally for their cosponsorship. I also want to thank the
Elder Justice Coalition, which is comprised of hundreds of elder abuse advocacy
groups, for its endorsement. The National Adult Protective Services
Association, the Alzheimer’s Impact Movement, and the Alzheimer’s Association,
among others, also have endorsed this legislation.
We’ve all seen
the news articles about the devastation this pandemic has caused in nursing homes
all across the country. With over 54,000 deaths in nursing homes now linked to
the coronavirus, such facilities remain hotspots for the coronavirus. One in
five nursing homes nationwide have reported cases of the coronavirus. And,
according to an article in yesterday’s New York Times, roughly 40
percent of all deaths attributable to this virus have occurred in long-term
Some of our
colleagues have argued that the fault for every one of these fatalities lies
entirely with the Trump Administration. That’s far too simplistic and, quite
frankly, partisan an explanation. It’s also just incorrect, as government
watchdog agencies have for many years described shortfalls in nursing home
oversight. These shortfalls persisted over multiple administrations. And, of
course, oversight of nursing facilities is a shared Federal-State
responsibility, with States playing the primary role in licensing and
inspecting these facilities.
A less partisan,
more complex, and far more meaningful answer is that COVID-19 only exacerbated
problems with which nursing homes struggled for many years prior to the
pandemic. Having worked on this area for many years, including as Aging
Chairman, I am acutely aware of these shortfalls.
First, as is
evident from nonpartisan reports by the Government Accountability Office over
the last two decades, there’s been a slow, but consistent downward decline in
the quality of care provided by many nursing facilities over the years. These
shortfalls, including infection control deficiencies and inadequate staffing,
played a huge role in this year’s transmission of the virus in nursing homes.
For example, as
noted last month by GAO, 82 percent of all nursing homes have been cited at
least once in a recent four-year period for infection control issues. Examples
of these deficiencies include not wearing masks or other personal protective
equipment and inadequate handwashing. Infection control issues were, in fact,
the most common deficiency cited in nursing homes. About half of nursing homes
had persistent problems in this area and were cited more than once across
Second, this dire
situation in nursing homes during the emergency is due, in part, to the
vulnerabilities of nursing home residents. These typically are elderly, frail
individuals. Many have preexisting conditions that make them more susceptible
than the young, on average, to the most brutal effects of the coronavirus. This
has been widely documented.
home fatalities during this pandemic are also due in part to staffing
shortfalls at many nursing facilities, coupled with the close quarters in which
most residents live. As underscored by researchers and the media, nursing homes
have struggled with staffing issues for years. For example, as noted by the Pittsburgh
Post Gazette, “Pennsylvania’s already low minimum staffing requirements,
long criticized as “totally unsafe,” were exacerbated by the pandemic.”
Pennsylvania reportedly has the seventh highest death rate for residents of
long-term care facilities, with 69 percent of the state’s COVID-19 fatalities
attributable to nursing and personal care facilities.
Too many lives
have already been lost to the coronavirus, and without bold action many more
will be lost. In my home state of Iowa, more than half the fatalities due to
this virus have occurred in nursing homes or other long-term care facilities.
That’s why we’re
introducing this legislation today. It will give facilities the resources they
need to protect personnel and workers, curbing the further spread of the virus.
The requirements in our legislation, which will not take effect unless
emergency funding is attached, ensure that states will devote additional
resources to this issue, at levels determined by the Centers for Disease Control
and Prevention, in consultation with the Federal Emergency Management Agency
and the Department of Health and Human Services (HHS).
Among the bill’s
major provisions, which apply mainly to nursing homes participating in the
Medicare and Medicaid programs, is the requirement that they report coronavirus
cases and fatalities for the entire 2020 calendar year to the Centers for
Disease Control and Prevention.
The bill also
ensures that States receiving Federal relief assistance during the emergency
period must devote some of the emergency funding to statewide or regional
strike teams that can promptly respond to COVID–19-related crises in nursing
homes that are overwhelmed by the pandemic.
Federal relief assistance will be devoted to televisitation. This provision
will ensure that nursing home and assisted living facility residents, who are
isolated during the emergency, can communicate with outside family and friends.
As the former
Aging Committee chairman and as a member and chairman of the Finance
Committee, I’ve long sounded the alarm about the many challenges that nursing
homes face. Unfortunately, it has taken a pandemic of historic proportions to
elevate these issues to national attention.
Last year, as
Chairman of the Senate Finance Committee, I convened two hearings that
highlighted abuse and neglect in nursing homes. The reforms in this legislation
will improve oversight of these facilities and give families peace of mind that
their loved ones will be treated with dignity and respect. To that end, this
legislation also extends funding for programs, such as elder abuse forensic
centers and long-term care ombudsman training, established under the Elder
Justice Act of 2010.
The bill also
provides that adult protective services agencies across the country can receive
$60 million in emergency funding to investigate increased abuse of senior
citizens. This provision recognizes that social isolation only increases the
risks of abuse, and some senior citizens may be at greater risk during this
emergency period due to the issuance of stay-at-home orders.
bill includes nursing home reform provisions that the HHS Inspector General
recommended or that respond to issues raised at the two nursing home hearings
we held in 2019. I urge all of my colleagues to cosponsor this critical