At the 2012 national conference for the Association for Professionals in Infection Control and Epidemiology ( APIC ), a health policy analyst from the Department of Health and Human Services , of which CMS is an agency , was asked to describe the current state of the science of HAI prevention in long-term care facilities , specifically nursing homes . He responded that it was an abysmal failure . Seven years later , in 2019 , things had not changed . with the training , supplies and resources it has and without the resources it needs and have asked for , does it make sense to interfere with their efforts and send investigators to point fingers and impose hundreds of thousands of dollars in fines rather than sending the aid needed to provide treatment to those afflicted by the pandemic ?” Nursing homes need government partners , not government predators during the ongoing tsunami of COVID-19 . A good analogy is to ask why a fire inspector is finding fault with firefighters ’ actions while the fire rages all around them .
The direct commitment of long-term care ( LTC ) professionals in nursing homes and other LTC facilities is to improve the quality of life of predominately older persons . Unfortunately , there are huge impediments that negate the commitment and negatively affect patients , residents , and staff .
Fortunately , there are success stories , but sadly , many of them go unreported .
Yes , there are stars to be found in the galaxy of nursing homes , but even with the telescope of investigations , the universe appears sparsely populated with five-star facilities .
One state attorney general ( AG ) who is involved in an ongoing investigation has released information that is not only unacceptable but outright abhorrent . Sadly , many of this AG ’ s findings are common among nursing homes in the U . S . Here are some of the highlights of that report :
● A larger number of nursing home residents died from COVID-19 than Department of Health data reflected .
● Lack of compliance with infection control protocols put residents at increased risk of harm .
● Nursing homes that entered the pandemic with low CMS staffing ratings had higher COVID-19 fatality rates .
● Insufficient personal protective equipment ( PPE ) for nursing home staff puts residents at increased risk of harm .
● Insufficient COVID-19 testing for residents and staff in the early stages of the pandemic put residents at increased risk of harm .
●The current state reimbursement model for nursing homes gives a financial incentive to owners of for-profit nursing homes to transfer funds to related parties ( ultimately increasing their profit ) instead of investing in higher staffing and PPE levels .
●Lack of nursing home compliance with the state governor ’ s executive order requiring communication with family members caused avoidable pain and distress ; and
●Government guidance requiring the admission of COVID-19 patients into nursing homes may have put residents at increased risk of harm in some facilities . It may have obscured the data available to assess that risk .
●The COVID-19 pandemic exposed many failings that were and continue to exist in nursing homes . Most shocking is a lack of compliance with infection prevention and control policies such as :
●Failing to isolate residents who tested positive for COVID-19 properly .
●Failing to adequately screen or test employees for COVID-19 .
●Demanding that sick employees continue to work and care for residents or face retaliation or termination .
●Failing to screen staff members properly before allowing them to enter the facility to work with residents .
●Failing to train employees in infection control protocols . ●Failing to obtain , fit , and train caregivers with PPE .
Pre-existing medical conditions and morbidity may contribute to the number of deaths experienced in nursing homes in the U . S . but failing to train and equip staff adequately has been a direct contributor to COVID-19 deaths .
As of the end of January 2021 , 39 percent of COVID-19 deaths have occurred in nursing homes . A new report from AARP revealed quicker actions could have prevented a great many deaths .
According to the report , CMS gave $ 21 billion in federal relief funds to nursing homes nationally , with only $ 2.5 billion allocated toward infection control , with the rest granted with “ no strings attached ,” the report said . Seventy percent of LTC facilities are for-profit , according to the report . And those for-profit facilities are linked to higher death rates . Where did the remaining $ 18.5 billion go ?
AARP asked : “ Who ’ s to blame for the 100,000 + COVID dead in long-term care ?”
From the early days of the COVID-19 pandemic outbreak , finger-pointing has been widespread and blame placed at the feet of a single nursing home by federal and Washington state inspectors , but the causes were laid decades ago and not in Kirkland , Wash . Who and what is at fault ?
Outdated Laws
• 1950s laws led to hospital-like settings for most nursing homes
• 1960s laws ultimately made nursing homes reliant on government funding
• Medicaid rules force many into nursing homes against their desires .
Government officials , both elected and career bureaucrats
• Early pandemic decisions deprioritized nursing homes .
• Months of limited testing let the virus go unchecked .
• It wasn ’ t until September 2020 until wide-spread testing was recommended .
• CMS directed nursing homes to ban visitors and nonessential personnel and restrict residents ’