SUNDAY TALK: Grassley on Nursing Homes and COVID-19

Q: What concerns do you have about nursing homes during the coronavirus pandemic?

A: Protecting the health and safety of patients, residents and their care providers is the number one concern. That’s why the Trump administration in March issued a temporary ban restricting non-essential visitors to these facilities during the coronavirus pandemic. Although the restrictions present isolation and hardship among nursing home residents and their loved ones, the need to stop the spread is especially critical in nursing homes where transmission of the highly contagious virus that can lead to severe respiratory infection puts residents and their caretakers at risk. The federal government has a fundamental responsibility to ensure the tens of billions of tax dollars that pay for long-term care for the nation’s elderly provide quality, accountable care. About three-fourths of the nation’s nursing homes and long-term care facilities receive Medicaid and Medicare reimbursements. The coronavirus pandemic has confirmed what my oversight work of the nation’s nursing homes and long-term care facilities has shown for decades. Without strong oversight and enforcement of laws and regulations, accountability and compliance can fall short. When I resumed chairmanship of the Senate Finance Committee last year, I continued to lean in on my longstanding oversight work, conducting two hearings in 2019 focused on nursing home abuse and neglect. COVID-19 has hit long-term care facilities particularly hard. In fact, one of the first outbreaks reported in the United States occurred in a nursing home in the state of Washington. Since then, at least 10,000 deaths in our nation’s nursing homes have been attributed to COVID-19. Here in Iowa, more than half of coronavirus fatalities are from nursing home deaths, so far. Every American who requires the services of a long-term care facility deserves one that delivers quality standards of care, around-the-clock, from one shift to the next. And the millions of Americans who have a loved one residing in a nursing home deserve peace of mind that there’s an inspections process in place to ensure facilities are held accountable for these standards of care, such as infection control processes, adequate staffing levels, and protections from elder abuse.

Q: What reforms have you called for to improve patient and provider safety?

A: I wrote the top two Trump administration officials who directly implement and enforce compliance of federal nursing home standards to spell out my concerns regarding testing capacity, shortages of personal protective equipment, gaps in tracking and reporting data and spending transparency. In my letter, I pointed out that two-thirds of the nation’s nursing homes were cited for infection control failures in the recent past. I made clear that taxpayer-funded facilities caring for COVID-19 patients need to have adequate staffing, equipment and safety protocols in place to provide quality care. The highly contagious coronavirus underscores the urgent need to reduce transmission in our long-term care facilities where many residents also have preexisting health conditions. I requested details from the Department of Health and Human Services and CMS to ensure the effectiveness of federal guidelines to prevent workers and residents from catching and spreading the respiratory virus. Specifically, I’ve asked for an update on federal efforts to assist long-term care facilities and health care providers with COVID-19 testing, personal protective equipment and infection control procedures. I also advocated for federal guidelines to promote uniform tracking and reporting requirements so that policymakers can make informed decisions and deliver peace of mind to loved ones. Specifically, I called for prompt reporting of positive COVID-19 results to the family members of residents of long-term care facilities. I also encouraged the Trump administration to provide weekly updates on disbursement of the $100 billion earmarked for health and social services in the Coronavirus, Aid, Relief, and Economic Security (CARES) Act. I’ve asked for specific accounting to know where the funds have been distributed and to what extent long-term care facilities have received funding. A day after I sent my letter, CMS announced new reporting requirements calling upon nursing homes to report all cases directly to the Centers for Disease Control and Prevention (CDC) and to patients and their families within 12 hours of a COVID-19 diagnosis. I’ve also spoken directly with Vice President Pence to advocate for more testing in nursing homes and to get needed personal protective equipment to our front line workers who are caring for our nation’s nursing home residents. I’ll continue working to improve quality care in nursing homes during this public health emergency and beyond.

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