Articles Posted in Certification and Licensure

dementiadiagram-300x204Even as news organizations reported that the coronavirus pandemic has taken a grievous toll on seniors institutionalized with dementia, a presidential panel on nursing home care split over common sense but limp recommendations on how the nation might reduce Covid-19’s savaging of the old, sick, and injured in long-term care facilities.

The unsurprising, 180-plus pages of recommendations from the Coronavirus Commission on Safety and Quality in Nursing Homes to the Trump Administration and specifically its long-term care facility watchdog Centers for Medicaid and Medicare Services (CMS) included calls for: “More money for testing, for personal protective equipment (PPE), for registered nurses, for infection control training and staff salary increases,” the Washington Post reported.

Seema Verma, the CMS chief who has led a calamitous federal response in long-term care that has left at least 77,000 vulnerable residents dead — 40% of all the coronavirus fatalities in the nation — and not quite a half million infected, tried to spin the commission’s findings.

demattos-150x150Maryland officials have wrapped up pandemic-prompted inspections of 226 nursing homes with a pricey rebuke to long-term care facilities that have failed still to safeguard the elderly, sick, and injured from Covid-19, putting them at “immediate jeopardy,” instead.

Three facilities were slapped with six-figure fines after state inspectors faulted them in June and July for improperly isolating potentially contagious residents, including new admissions: Collingswood Rehabilitation and Healthcare Center ($275,000) and Potomac Valley Rehabilitation and Healthcare Center ($120,000), and Kensington Healthcare Center ($294,000).

Inspectors also asserted that a patient died at Potomac Valley after a nurse failed to provide basic life support, and the Washington Post reported, based on state data, that “at least 78 residents from the three facilities have died since the spring of Covid-19 … and more than 270 have been infected with the virus.”

candymexico-300x169Stepped up vaccinations, bans on junk food for kids, worries about domestic abuse and booze consumption by men — yes, these seemingly disparate things have something in common. They’re all getting heightened attention from experts due to the coronavirus pandemic.

Let’s start with a grito (a whoop) for the leyes antichatarra or anti-junk food laws targeting youngsters and spreading across states in Mexico. The laws take aim at high calorie, low nutritional value foods and drinks, the Washington Post reported:

“[They would prohibit the sale of] chips, candy, soda and other sugar-sweetened beverages to children under 18, putting these foods in the same category as cigarettes and alcohol. The law[s establish] fines, store closures and jail time for repeat offenders. The ban also applies to vending machines in schools.”

hhslogoaug20-300x300In response to the shattering harms of the Covid-19 pandemic, Congress sought to shore up the U.S. health care system with billions of dollars in emergency aid. But the federal agency that helps to oversee the institutional care for the elderly, sick, and injured performed poorly as a steward of taxpayers’ hard-earned money.

The Health and Human Services department, instead, shoveled hundreds of millions of dollars, “no strings attached,” to dubious owners or operators of facilities nationwide. These “for-profit nursing home providers … have faced accusations of Medicare fraud and kickbacks, labor violations or widespread failures in patient care,” the Washington Post reported.

The newspaper said its analysis of HHS allocations of big sums in the Coronavirus Aid, Relief, and Economic Security Act, or Cares Act, also showed that:

bookingpicretamays-150x150She was a 46-year-old Army veteran hired by the Louis A. Johnson Medical Center in 2015 with no certification or license to care for patients. Reta Mays worked in the middle of the night, tending to elderly, onetime service personnel, sitting bedside and monitoring their vitals, including their blood sugar levels. Mays went room to room, largely unnoticed for three years on Ward 3A.

But as unexplained deaths mounted on the surgical unit between 2017 and 2018, the bespectacled mother of three — who had served in the Army National Guard and had deployed to Iraq and Kuwait — shifted from being a nurse’s aide to becoming a murder suspect.

She now has confirmed in court that she injected multiple doses of insulin in at least seven patients in the rural Veterans Affairs hospital a few hours away from the nation’s capital, causing the frail victims’ blood glucose levels to plunge in fatal fashion.

cmschiefSeemaVerma-150x150With the calendar pages flying off to the fall presidential elections, why isn’t today an excellent time for President Trump to thank Seema Verma for her service and send her packing as head of the Centers for Medicare and Medicaid Services (CMS) in the Department of Health and Human Services?

Two news organizations — Vox and Politico — have posted detailed and disturbing takedowns of CMS and its oversight failures that have helped to worsen the terrible Covid-19 toll in the nation’s nursing homes and other long-term care facilities.

CMS, for example, halted nursing home inspections as the pandemic broke out — with disastrous consequences, as the Washington Post explains in a separate report. The agency earlier had also acceded to industry bleating about tough regulation, with Verma and her agency relaxing fines on owners and operators for detected problems and easing training requirements for under paid, over worked, and already ill-trained caregivers. The training standards have gotten so lax that a reporter, in 40 minutes of online effort, became certified temporarily to be a 24/7 caregiving aide.

covidSEvetcenter-300x200To paraphrase the late, great writer and activist Maya Angelou, nursing homes and other long-term care facilities are showing the public in the middle of this pandemic just truly what they are.

It is hard to believe, still, the shabby way they are treating the aged, sick, and injured. Just consider this sampling of recent news reports:

“Care” facilities — including centers dealing with veterans — have been too willing to subject residents to risky medical experimentation to fight the novel coronavirus, including what appear to be  inappropriate treatments with a much-promoted anti-malarial drug. This echoes a situation involving nursing home residents in Galveston, Texas,  and their facility’s dosing them with hydroxychlorquine without their loved ones’ knowledge and iffy circumstances about their individual capacity to consent to receiving the drug. As the Washington Post reported of a Philadelphia area veterans’ facility (shown in federal photo above):

covidpleasantview-home-300x111Owners and operators of nursing homes and other long-term care facilities have mounted a “nimfy” (Not My Fault) defense for the tens of thousands of deaths and infections of their residents during the Covid-19 pandemic. They claim they did the best they could under tough circumstances. And now they want not only special legal protections from those who suffered harms but also taxpayer bailouts.

But the industry’s disingenuous bleating has a big problem: It gets undercut by the second by infuriating actions — including by profit-mongering facilities “dumping” thousands of aged, sick, and injured residents on the streets or into flophouses, and by homes that still fail — despite warnings and penalties — to take basic steps to safeguard the vulnerable.

The New York Times — conducting the kind of sleuthing that real federal watchdogs could be taking on — reached out to “more than 80 state-funded nursing-home ombudsmen in 46 states” to detail “involuntary discharges.” As the newspaper explained of these inappropriate evictions by care giving centers, which may number more than 6,400 nationally:

capnurse-300x169What’s in a name? The Covid-19 pandemic should force a major change in the big misnomer of long-term care institutions: Let’s stop labeling them with the term nursing — as if they provide significant medical services to the elderly, sick, and injured.

Instead, the coronavirus may lead the public to bust the myth put forward by owners and operators of nursing homes, skilled nursing facilities, assisted living centers, and other similar centers about how they treat some of the nation’s most vulnerable people, especially based on growing evidence amassing in news reports.

The care facilities knew they were not hospitals, with extensive equipment and highly trained doctors and nurses. The facilities found they often were sorely lacking gear — especially personal protective equipment. They too many times did not have the staff with the skills or training to treat already fragile residents infected with the novel coronavirus or recuperating from significant bouts with a debilitating illness. They did not have the Covid-19 tests they needed. They struggled to isolate the infected.

cmsnursinghomecases-300x146Federal regulators have issued, at long last, the data they have collected on the novel coronavirus’ effect on nursing homes, giving an incomplete but still  devastating look at how in just a few months some of the nation’s most vulnerable people have been savaged by Covid-19.

With 12% of the nation’s nursing 15,000 homes yet to report, the Centers for Medicare and Medicaid Services (CMS) has tallied “25,923 resident deaths tied to Covid-19 … and 449 deaths among the facilities’ staff. The [U.S.] survey also found about 95,000 infection cases at nursing homes across 49 states, about a third of them among staff members,” the Wall Street Journal reported.

The newspaper finds that figure far too low, noting:

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