Articles Posted in Nursing homes

cnnhoustonvaxprotest-300x169In the crunch to quell the coronavirus pandemic and to do so by getting as many people as possible their protective shots, public health officials consistently have stressed a big V in the national vaccination campaign: Voluntary.

But as hundreds of millions of people around the globe have willingly gotten them and the vaccines have shown to be overwhelmingly safe and effective, the unvaccinated may get leaned on with more than pleas, nudges, and incentives.

They may notice this quiet push in the workplace, especially if they hold health-related jobs, and at schools. The result may be to resurface the fiery and counter-factual anti-vaccination extremism in the country.

brooks-lasureandbecerra-300x240Chiquita Brooks-LaSure has won U.S. Senate confirmation and will become the first black woman to lead the federal Centers for Medicare and Medicaid Services or CMS.

The longtime government official, who was an adviser to President Obama and has served in multiple other top federal roles (shown right, with her boss, Health and Human Services head Xavier Becerra), jumps into a role with gigantic challenges. These include:

  • The administration by her agency of federal health insurance programs, including for children and those covered under the Affordable Care Act. The Biden Administration and Democrats, as part of coronavirus pandemic rescue efforts, bolstered Obamacare and opened enrollment in it, with subsidies, to millions of Americans slammed by the coronavirus pandemic. But those efforts, which have boosted ACA enrollment, also will need renewed legislative support — which may occur right as the midterm elections are under way. CMS also may be a key part of some Democrats’ plans to improve health care coverage in this country by lowering the qualifying age for Medicare for 60-something Americans who often must pay staggering premiums and who lose jobs and employer-related coverage at scary rates. This is an idea that Republicans reject.

cdcnhomesmay72021-300x156Residents and their loved ones may have reached a major turning point with nursing homes and other long-term care facilities, agonizing as to whether the institutions really can provide safe, hygienic, and welcoming places for the vulnerable — or whether other, tough options must be considered.

Who can forget that that 132,000 elderly, injured, and seriously ill residents died of the coronavirus during the many months of the pandemic, and almost 1.4 million infections were recorded in 38,000 long-term care facilities? The institutions — even as the pandemic’s terrible toll keeps rising — still account for a third of all U.S. deaths due to the disease.

The facilities’ covid-related deaths have plummeted by 91% since December, especially as public health officials campaigned to get residents and staff vaccinated, the New York Times reported (see chart above, based on federal data). But public confidence in long-term care facilities also has plunged, as reflected in admissions and occupancy:

agedwalk-179x300As the coronavirus pandemic’s most catastrophic effects recede in nursing homes and other long-term care facilities, notably due to vaccinations and other public health measures, residents and their loved ones still face costly, confounding issues in safeguarding the aged, sick, and injured. The Biden Administration wants to spend hundreds of billions of dollars to help.

But will the plans founder due to Republican resistance? And will even a huge jolt of funding be enough to deal with a graying nation’s growing problems with long-term care?

Our own homes provide a cornerstone of Democratic proposals to deal better with nightmares with the cost, safety, and availability of long-term care. Instead of sinking yet more public money — via Medicare and Medicaid — into institutions, can the federal government, instead, improve funding so seniors, the ill, and injured can stay home and get treatment there? As the Washington Post reported:

covidcases032721-235x300In 25 states, including in Virginia and Maryland, data show coronavirus cases are running higher than U.S. averages and staying high. In seven states, notably Michigan, new virus-related deaths are increasing.

A half dozen states have recorded hundreds of confirmed cases involving corona virus infections with a variant known as B 117 that was first detected in Britain and may be more contagious and lethal. States up and down both coasts and in the Upper Midwest have reported dozens of infections involving a variant first detected in South Africa and known as B 1351. It, too, is believed to spread more easily and cause greater illness and death.

Across the country, an average of 58,000 coronaviruses are occurring daily. The country has exceeded 30 million infections and the nation is approaching 550,000 deaths due to the disease.

covidpollhealthworkersmarch21-300x138The battle to quell the coronavirus pandemic has opened new divides among us — splitting those willing and not to get vaccinated against the disease, those who will adjust easily or not to life when the illness is a less dominant factor, and those who do not recover easily or quickly and struggle long after their tough bouts with the virus.

Will these differences widen further and create greater challenge for public health officials and political leaders, or can successes in fighting Covid-19 help smooth over rifts?

As vaccine supplies and vaccination sites grow and more than 100 million Americans have now gotten at least one coronavirus shot, concerns persist about equity and hesitancy in the national inoculation campaign.

cmsnursinghomecompare-300x139Federal regulators, by allowing owners and operators to self-report quality and safety data and failing to audit vital information with diligence, have “broken” the national nursing-home rating system — what was supposed to be an invaluable tool for consumers to make life-and-death decisions about where to place vulnerable loved ones needing round-the-clock care.

Instead, the New York Times reported, the popular and convenient star rankings have become little more than an inaccurate means for facilities to advertise and market themselves, even while keeping from the public their serious problems — including abuse, neglect, over medication, sexual assault, and killings of the aged, injured, and ailing.

The system’s glaring shortcomings were exposed even more by the coronavirus pandemic, the newspaper reported. It launched its deep dig into the ratings when it became clear that highly rated homes, when the pandemic struck, did not fare notably better, as might be expected.

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.

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