Benefit Bulletin: August 2020

Benefit Bulletin: August 2020

Coronavirus Has Devastating Impact On Nursing Homes: Full Scope Still Unclear

By Rick Delaney

COVID-19 has been particularly dangerous for older and sicker people living in nursing homes.  One example of just how quickly it can spread is a nursing home in Maryland’s Carroll County.  On March 26 of this year, a resident tested positive for the coronavirus.  Two weeks later, the number of confirmed cases was 77 out of 95 residents along with 24 staff members.  At least 28 residents have died.

Three months after our nation’s March 15th lockdown due to the coronavirus, half of all nursing homes in the U.S. had yet to be inspected for procedures to stop the spread of the coronavirus.  Meanwhile, the federal government fumbled the collection of nursing home coronavirus data, and is struggling to determine the accurate number of cases and deaths.

Data from the Centers for Medicare and Medicaid Services (CMS), indicate that coronavirus fatalities accounted for at least one-third of the deaths in long-term care facilities in 26 states and more than half of deaths in 14 of those states.  Based on data through May 31, 2020, CMS reports that COVID-19 caused 31,782 deaths among nursing home residents and staff across the country, with about 12% of facilities still to report.

Less than 24 hours after that data was released, local media outlets began reporting that there were “clear problems” with the data.  In Virginia, CMS case numbers showed a sharp discrepancy with the data supplied by the state.  According to the Virginia Department of Health, the state had 3,514 cases of the virus at nursing homes, more than double the number reported by CMS — 1,443 cases — and there was no information at all for 29 Virginia nursing homes.

The full extent of the coronavirus impact during the first three months of the coronavirus remains unclear.  Before CMS even released the new data, CMS officials acknowledged there were likely discrepancies.  The lack of inspections and reliable federal data,

is leaving nursing home residents, families and senior advocates in the dark about the pandemic’s out-sized effect on older Americans, and the safety of our nation’s long-term care facilities.

From the start of the coronavirus, nursing homes have been hampered by a lack of personal protective gear like face masks, gloves and disposable gowns and COVID-19 tests.  It took two months after the first cases of COVID-19 were found in the U.S., before the federal government finally said it wanted all nursing home residents and staff to be tested.  But three weeks later, neither the federal government or states had given long-term care facilities the money and supplies necessary to carry this out.  By May, the governors of several states had called on the National Guard to provide COVID-19 testing at their states’ nursing homes.

It was almost three months after the March 15th federal lockdown before many states started receiving the N95 masks, face shields and gowns necessary to perform nursing home inspections.  This lack of a national plan to provide early and rapid COVID-19 testing in nursing homes, as well as to provide protective equipment for staff, made it easier for the virus to spread quickly and hundreds of lives to be lost.  These problems have plagued the entire U.S. healthcare system as well.

Some health experts are saying that the coronavirus alone doesn’t explain the losses in long-term care residences.  Many senior advocates point to lapses in infection control and chronic staffing shortages, two problems that have affected nursing homes for decades.  Medicare doesn’t cover long-term care, only temporary stays in nursing homes after qualifying hospitalizations.  This makes nursing homes reliant on Medicaid for most of their funding, which pays lower fees than Medicare.  There have been repeated efforts over the years, most recently in efforts to repeal the 2010 Affordable Care Act, that would have cut federal spending on Medicaid.

Roughly 55% of participants in TSCL June Senior Cost Survey feel that we need to invest more in our national healthcare system so that we can respond rapidly and effectively to protect public health.  Rest assured, TSCL is working to make every Member of Congress aware of your strong support for protecting Medicare and your health!


Sources:  “Nursing Homes Go Unchecked As Fatalities Mount,” Politico, June 15, 2020.  “How Does The U.S. Healthcare System Compare to Other Countries?” Peter G. Peterson Foundation, July 22, 2019.  “Nursing Home Virus Data Riddled With Errors,” Kate Masters, The Virginia Mercury, June 8, 2020.