Q & A: October 2020

Q & A: October 2020

Is Medicare Doing Anything to Help Nursing Home Patients?

Q: My 94-year-old mom has been living with me for the past five years.  Since the coronavirus pandemic started, her dementia has worsened rapidly.  Recently she fell out of bed, and now fearful of bone fractures and other injuries, the family is discussing nursing home care.  We are all afraid of the high level of COVID-19 found in many facilities.  What is Medicare doing to help make nursing home care safer?

A:  COVID-19 is reaping a terrible toll on our nation’s 2.5 million nursing home residents.  Although people living in nursing homes make up less than 1% of the U.S. population, but they account for roughly 40% of all deaths from COVID-19 among people age 65 and up.  In a like manner, people like your mom and others with developmental disabilities are also at high risk due to their medically fragile health conditions and the difficulty of being able to ensure safe care in the home, especially falls.

The Centers for Medicare and Medicaid Services (CMS) announced in late July that it is providing an extra $5 billion in funding to help nursing facilities deal with the coronavirus.  CMS said the money will be directed towards ongoing testing of nursing home staff, providing states with a weekly update of facilities with increased COVID-19 cases, and offering additional training and support.  But so far, the government’s efforts to protect nursing home patients have had mixed results.

Prior to this, nursing homes received $4.9 billion in relief from pandemic funds approved by Congress.  But The New York Times recently reported that FEMA sent out some defective and unusable personal protective gear.  Some of the shipments included expired surgical masks with elastic bands so brittle that they snapped when stretched, isolation gowns that resembled oversize trash bags which had no holes for arms, and extra small gloves that didn’t fit the typical health worker’s hands.

Particularly troubling are reports from many states that the federal government’s failure to co-ordinate the acquisition of personal protective equipment (PPE) has forced states, cities, and big hospitals chains to compete with each other for scarce supplies, and prices have soared.

While Medicare is sorting out the best way to help nursing home patients, keep in mind that Medicare’s coverage of nursing homes is limited to temporary stays after a qualifying stay as a hospital in-patient.  Medicaid is the largest source of funding for nursing homes along with in-home long-term service and support.

For families with someone needing long term care, there are no easy answers, only difficult decisions.  A lot depends on a family’s ability to safely provide care and address the patient’s medical needs.  Talk to your mom’s doctor and find out what he or she would prescribe as a plan of care.  Look for a nursing home in your area with a good record on fighting COVID-19.



“Building The Long-Term Care System Of The Future:  Will the COVID-19 Nursing Home Tragedies Lead To Real Reform,” Bruce Allen Chernof, Cindy Mann, Health Affairs, July 31, 2020.  “FEMA Sends Faulty Protective Gear to Nursing Homes Battling Virus,” Andrew Jacobs, The New York Times, July 24, 2020.