Articles Posted in Nursing Care

adjustedmay21covidcases-300x158Even as millions of us glide into a summer with high hopes of putting the pandemic behind us and returning to greater normality, huge public health challenges persist in quelling coronavirus infections, chief among them being — how the heck do we get the unwilling vaccinated now?

Just before the long Memorial Day holiday weekend launched, the head of the federal Centers for Disease Control warned that the nation has reached the difficult — and promising —  point where experts figuratively can see either a glass half empty or half full.

At least half of the nation’s population now is fully vaccinated, the agency reported, with 61% of adults (those 18+) having received at least one vaccine dose. Millions of parents are hurrying to ensure that those as young as 12 receive their coronavirus shots, as now not one but two vaccine makers have developed data showing products to be safe and effective for younger patients.

churninnhomes-300x300Churn may be a wonderful word when discussing fresh milk, heavy cream, and butter. But it can be a nightmare term for the too-common, rapid, and lethal turnover that occurs in health staff at nursing homes and other long-term care facilities.

Personnel turnover left the aged, injured, and ailing residents at care centers, with an average annual health staff churn-rate of 128% and some facilities hitting as high as 300%, even more vulnerable during the coronavirus pandemic, a new study reported.

David Grabowski, a professor of health care policy at Harvard Medical School and one of the study’s authors, told the New York Times of the information he and his colleagues gathered:

declinenhomedeathsnytfeb21-300x189Just as good news expands about vaccines and declining coronavirus cases and deaths in the nation’s nursing homes and other long-term care facilities, grim information also is developing on how the facilities’ ownership, particularly by wealthy investors, can be lethal to residents.

The positive effects of early efforts to get vulnerable long-term care residents and staff vaccinated can be seen in the accompanying graphic (courtesy of the New York Times). The newspaper reported this:

“Throughout the pandemic, there has been perhaps nowhere more dangerous than a nursing home. The coronavirus has raced through some 31,000 long-term care facilities in the United States, killing more than 163,000 residents and employees and accounting for more than a third of all virus deaths since the late spring. But for the first time since the American outbreak began roughly a year ago — at a nursing care center in Kirkland, Wash. — the threat inside nursing homes may have finally reached a turning point. Since the arrival of vaccines, which were prioritized to long-term care facilities starting in late December, new cases and deaths in nursing homes, a large subset of long-term care facilities, have fallen steeply, outpacing national declines, according to a New York Times analysis of federal data. The turnaround is an encouraging sign for vaccine effectiveness and offers an early glimpse at what may be in store for the rest of the country, as more and more people get vaccinated.

covidhospitalsnov-259x300As the winter of 2020-21 descends, the coronavirus pandemic is raging, unchecked, from coast-to-coast while the folks in control of the federal government sulk and seem to have checked out from their governing roles.

The numbers likely are understated.  But roughly 265,000 Americans have been killed by the Covid-19 virus and more than 13 million of us have been infected with it. Records are falling left and right, as reported cases skyrocket daily — from thousands, to tens of thousands, and now to more than 200,000 per day. The number of new cases in November alone jumped past 4 million, compared with the October record of 1.9 million.

A significant goal of public health battles with the coronavirus — to prevent the U.S. health system from getting overwhelmed with cases, slashing at all medical services and not just Covid-19 treatment — is under major threat. That’s because the nation is busting records on coronavirus hospitalizations, sitting at 90,000 patients and heading toward the fearsome number of 100,000.

With the pandemic  tearing through the United States and overwhelming U.S. health care system,  we pause from the grim news to tally  some of the nation’s blessings in this time.

We can be thankful for the courage, fortitude, dedication, and skill of an army of health workers of all kinds. They have put themselves and their loved ones at formidable risk and strain to treat patients under unprecedented duress. They have dealt with fear and uncertainty, giving little quarter, and approaching their own breaking points. Some health workers have themselves fallen ill, with some dying. Their sacrifices cannot be forgotten, and we need to give sustained and extra support to health workers as the pandemic enters its next perilous phase.

nhomehall-300x206Covid-19 infections and deaths are spiking anew in nursing homes and other long-term care facilities, hitting worrisome levels not seen since months ago in the pandemic. The unchecked mess in centers nationwide, but especially in the South and West, is prompting more attention to them — from lobbyists boasting White House ties, health worker “strike teams,” and Big Pharma investigators.

But even as the nation’s top overseer of long-term care calls on institutions to step up their infection control and other coronavirus-fighting efforts, researchers say that 1 in 5 nursing homes and other long-term care facilities report they lack enough personal protective equipment and staff. This occurred as recently as in July — not just at the start of the pandemic.

Even as Seema Verma, the head of the Centers for Medicare and Medicaid Services, told the owners and operators of care facilities that her agency has “deep concern … that even in nursing homes that are doing testing on a regular basis, we are still seeing significant spread,” experts from Harvard and the University of Rochester published findings on nursing homes in a health care policy journal, concluding:

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:

covidnhnoplan-276x300With hurricanes, wildfires and other calamities, authorities pound home to the public the importance of preparedness. So why should preparing for an infection outbreak be any different? Yet more disclosures have raised disturbing questions about the dearth of crucial emergency planning by nursing homes and other long-term care facilities, their owners and operators, and federal and state regulators.

Taxpayers likely will foot hefty bills — a new estimate says it may be $15 billion  —in the days ahead for facilities’ active resistance to oversight and forward thinking. These lapses played a part in the terrible toll in failing to safeguard the old, sick, and injured, and first responders and health care workers, too, reported ProPublica, a Pulitzer Prize-winning investigative site.

It cites data from AARP about the nationwide deaths in long-term care centers inflicted by the novel coronavirus:

covidmdnatguard-300x174Federal and state officials almost seem as if they are competing with each other to race to new lows in their wrong-headed failure to protect elderly, sick, and injured Americans who require institutional care and whose health and lives are being savaged by the novel coronavirus.

An estimated 1.5 million Americans live in long-term institutions, including nursing homes, assisted living centers, skilled nursing facilities, memory care hospitals and the like. Covid-19 has taken a terrible toll on these frail, chronically ill, or seriously injured and debilitated people with more than 27,000 residents and staff dying from the novel coronavirus — roughly a third of all the disease fatalities nationwide. A third of the coronavirus deaths in the District of Columbia have been in skilled nursing facilities, while 40% of the Covid-19 deaths in California, the nation’s largest state, have been in nursing homes.

In the latest baffling response, President Trump and Vice President Mike Pence both suddenly have  “recommended” that states get nursing homes and other similar facilities to step up the testing of residents and staff.  They did not make this common-sense step mandatory, nor did they offer any word on how the federal government could help achieve this. As the Associated Press reported:

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