Maryland will take the lead among states in the area in re-opening nursing homes and other long-term care facilities from months of coronavirus-related closures to family members, guests, and other visitors.
Gov. Larry Hogan (shown, right) acted as the state, for the first time in months, reported that October started with zero Covid-19 fatalities and 76 of Maryland’s 227 nursing homes had active coronavirus cases — down from 130 on Aug. 5, the Washington Post reported.
After struggling through some of the worst outbreaks in long-term facilities in the area, Maryland will put significant resources into safeguarding nursing homes as they reopen, Hogan said.
The state says it has a handle on testing at the facilities — an issue that persists as a nightmare nationwide due to a shambolic federal response.
As the newspaper reported:
“Hogan said the state will commit an additional $6 million to help nursing homes and assisted-living facilities pay for staff testing after some said they couldn’t afford the costs. He also said health officials are launching new guidelines to expand the use of rapid antigen tests, which could be used to screen visitors …
“The governor said that through a bipartisan interstate testing compact — which Hogan negotiated during the final days of his tenure as chair of the National Governors Association — the state has secured 250,000 rapid antigen tests that will be deployed at all of Maryland’s 227 nursing homes by next week. Maryland has recorded 2,155 deaths in nursing homes, assisted-living facilities and group homes since the pandemic began, making up more than half the state’s coronavirus fatalities. Those facilities have accounted for 15,798 reported cases in the state.”
Maryland’s reopening plans will affect facilities “with no active cases over the previous two weeks,” the newspaper said. When outsiders go to the centers “strict physical distancing measures and mask-wearing policies will be in place….” As was also reported:
“Hogan’s order prohibits indoor visitations if a jurisdiction’s coronavirus test positivity rate passes 10%, although every locality in the state is well below that mark.”
As for similar facilities elsewhere in the region, the Washington Post reported:
“In Virginia and [the District of Columbia], indoor visits remain limited to situations in which a facility resident is close to death. Outdoor visits with masks and social distancing are allowed.”
CMS creates ‘testing hell’ for homes nationwide
Nationally, long-term care facilities have found themselves in “testing hell,” as the New York Times reported of recent new regulations from the industry’s oversight agency, the Centers for Medicaid and Medicare Services (CMS):
“After months of enduring a dearth of protective medical gear and staggering death tolls from the coronavirus pandemic, nursing home operators and employees across the United States experienced something close to elation as rapid-result test machines paid for by the federal government began arriving last month at 14,000 residential facilities that serve the elderly. The hand-held testing devices, which spit out results in as little as 15 minutes, were intended to quickly diagnose and isolate patients, and alter the deadly calculus of a contagion that has taken the lives of 77,000 nursing home residents and workers, more than 40% of the nation’s fatalities from Covid-19.
“But the initial sense of relief has been overtaken by frustration as nursing homes have discovered that they must pay for test kits on their own, and that the machines are markedly less accurate than lab-based diagnostics. Because the devices come with a modest starter-set of test supplies that only last a few weeks, facilities, many of them buffeted by financial losses from the pandemic, must pay roughly $32 for each additional test. In communities with high rates of infection, a typical nursing home can churn through hundreds of tests a week. Many nursing home operators also say they have been overwhelmed by new federal reporting rules, fines and financial incentives that are associated with the program.”
CMS officials insist they will be judicious and not punitive in enforcing their recently installed rules for long-term care owners and operators to return their operations to greater normality. The federal agency’s sterner approach came after months during which inspections were halted, facilities were shut, and CMS came under fire for failing to safeguard residents, as they disproportionately died and were infected. Agency leaders now claim they responded well, given the unprecedented circumstances.
The facts argue otherwise. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damages that can be inflicted on them and their loved ones by neglect and abuse in nursing homes and other long-term care facilities.
The coronavirus pandemic has taken a terrible toll on vulnerable and institutionalized residents and their loved ones, and, months in now, we need much stronger performance by regulators at the federal and state level, as well as by facilities’ owners and operators. With aggressive testing — for which Maryland deserves credit if its plans bear out. With appropriate supplies of personal protective equipment (PPE) for health workers. With contact tracing and suitable quarantine of the exposed and isolation of the ill.