The White House and Senate Republicans have failed to protect more than 1.3 million Americans in nursing homes and other long-term care facilities, with persistent inaction contributing to the rising toll of Covid-19 deaths and infections among the institutionalized — months after the crisis in long-term care exploded into the public consciousness.
Those are the new findings of Bob Casey and Ron Wyden, two ranking Democratic U.S. senators serving on the Aging and Finance committees, respectively. They issued their harsh criticisms and a minority staff report they requested and based on information from the Trump Administration. The Washington Post quoted Casey:
“This report lays bare the devastating cost that American families have paid as a result of the Trump administration’s incompetency and Republican inaction. The crisis in our nursing homes, which residents and workers and their families are experiencing every day, demands immediate action.”
Instead, Casey, Wyden, and Democratic staffers asserted that Trump has a “flippant disregard for medical science and our nation’s most vulnerable people,” resulting in a dearth of sound and desperately needed data to deal with the pandemic’s savaging of long-term care in the country. The report says this of the lack of medical and scientific evidence:
“More than eight months into the pandemic, the Trump Administration’s data on nursing homes still fails to fully capture the devastating toll of Covid-19, as there is no required data collection whatsoever on case counts and deaths that occurred prior to May 1. Further, alarmingly, the Trump Administration is still not collecting information that would shed light on the disparate impact that the pandemic is having on Black and Hispanic/Latinx individuals and other people of color in nursing homes.”
The Senate study notes that coronavirus deaths among residents and staff in long-term facilities is nearing 80,000, and long after owners, operators, politicians, and regulators knew from painful experience how Covid-19 would kill and sicken the aged, injured, and chronically sick in institutions:
“More than 16,800 nursing home residents and workers died of Covid-19 in July 2020 and August 2020. During those months, on average, more than one nursing home resident was infected every minute, and 11 residents died every hour.”
Besides failing to develop a data-based, realistic picture of the pandemic’s terrible toll, the ineffectual federal coronavirus response also has put health workers and residents both at high risk by bungling the adequate supply of personal protective equipment and testing. Officials and owners and operators have not begun to deal with staffing issues, too — both in chronic and increasing shortages that roughly 1 in 5 facilities experiences now in aides, not to mention the poor pay, lack of training, understaffing, and hardship of health workers.
Casey and Wyden tore into a much-promoted initiative by the Centers for Medicare and Medicaid Services (CMS) to send testing equipment and supplies to nursing homes, while requiring regular and more frequent tests of staff. They said this assistance has been too late (with many facilities protesting they are not getting promised materials), too little (the tests supplied are far too few and with no promises of help with restocking), and too sketchy (it is unclear whether the type of test provided will be useful in helping staff know which residents are infected and how to better care for them as a result).
The Democrats offered scathing assessments of the president and his political allies in power:
“Tens of thousands of grandparents, parents, veterans, neighbors, friends and essential workers might still be alive today had it not been for the president’s flippant disregard for medical science, the Trump Administration’s anemic response to the pandemic, and the fecklessness of Republicans in Congress.”
Still, after offering a handful of fundamental, common sense policy actions that should require urgent attention, the Democrats also suggested this:
“There will be a time for a reckoning, to reflect on this pandemic and ask what more could have been done. Until that time to comes, Congress must act to save lives in nursing homes. Inaction on these key proposals is an abdication of the highest degree by Republicans in Congress and the Trump Administration. It demands a course correction, as the lives of nursing home residents and workers hang in the balance.”
Criminal charges filed
Residents and their loved ones, of course, may seek redress for the harmful injustices inflicted on them during the pandemic by long-term institutions. It appears prosecutors also are stepping in, the New York Times reported on Sept. 25:
“Two former leaders of a Massachusetts veterans’ home were indicted on charges of criminal neglect in connection to a coronavirus outbreak that contributed to the deaths of at least 76 residents, the state’s attorney general said …Bennett Walsh, 50, and Dr. David Clinton, 71, were indicted … by a state grand jury on charges related to their work at the facility, the Holyoke Soldiers’ Home in Holyoke, Mass. Mr. Walsh had been the superintendent of the facility, and Dr. Clinton its medical director. ‘We believe this is the first criminal case in the country brought against those involved in nursing homes during the Covid-19 pandemic,’ the state attorney general, Maura Healey, said at a news conference …. The men face felony charges and if convicted they could face years or even decades in prison, she added.”
While defense lawyers for the accused said the charges were unfounded and a bad attempt to hold their clients to account for unprecedented circumstances caused the pandemic, prosecutors pointed to what they asserted were key and criminally negligent administrative decisions made by Walsh and Clinton. Officials asserted the two should have known and should not have allowed infected and un-infected patients to be put together side by side in a single unit of the home, an action that the facility defended saying it was so short on staff it had no choice.
This practice already drew a sharp official rebuke, the newspaper reported:
“In June, investigators released a 174-page report that depicted a facility in chaos, excoriated the decision to combine crowded wards and described conditions in nightmarish terms. In addition to cataloging a series of errors in protecting residents, the report quoted people who worked at the facility, including one who said it ‘felt like it was moving the concentration camp, we were moving these unknowing veterans off to die.’”
The New York Times reported this background on this facility: “The Soldiers’ Home in Holyoke [is] a state-run facility that provides health care, hospice care and other assistance to veterans …[It] housed frail veterans of World War II and other conflicts.” Officials at the U.S. Department of Veteran Affairs have tried to distance themselves from the calamity at Holyoke, noting the VA has little oversight or authority over state-run long-term facilities like it.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their damages inflicted on them and their loved ones by negligence and abuse at nursing homes and other long-term care facilities. These institutions, as the coronavirus has shown, demand urgent attention and improvement to their expensive and desperately needed care for some of the nation’s most vulnerable people.
It should not be a partisan concern for federal regulators to take dramatic actions to safeguard the health and lives of nursing home residents and others in long-term care. It is shocking that months into the pandemic, facilities may face slightly more oversight (inspections and fines) but insufficient real help in dealing with basic issues like adequate testing, isolating, and treating of individuals infected with the novel coronavirus. It is unacceptable that health workers struggle with sufficient supplies of PPE and testing, so they do not, as they toil in the work at various facilities, spread Covid-19 infections among them.
It is painful to see the alacrity with which political partisans will act to fill a U.S. Supreme Court seat, while taking a long vacation and engaging in bickering over and failing to act on measures to help nursing home residents, their loved ones, as well as health workers and other members of the public who have been hammered by the coronavirus. We’ve got a lot of work to do to ensure that the nation, and especially its long-term care capacities, end up in a spot not just near but far better than where they were before.