One COVID-19 Case Can Infect 50% of Nursing Home Residents “in a Matter of Hours”
Right or wrong, out here in rural Texas not many people are wearing masks. In stores, yes but not out on the streets. Americans are tired of doom and gloom predictions of millions of dead from the Chinese coronavirus. The closer we get to a vaccine, the more the public is willing to take chances. One area where we can’t afford chances are nursing homes.
During the early months of the pandemic, nursing homes were called “death pits” by the New York Times. Not a pretty label but we are aware of nursing homes were the infection rate was over 50% while in the general public it was less than 1%.
Nationally the infection rate is still relatively low. Sure, there are plenty of hotspots but most folks are still at relatively low risk. Once again, that doesn’t mean we can afford to take chances with America’s most precious assets, our elderly.
Infection rates spiked in California and the south after stay at home orders were lifted. Many folks are cautiously optimistic that we will make it to a vaccine this winter. Unfortunately, Medicare and a prominent medical publication sounded a new alarm today for nursing home patients. We are glad they did!
As the pandemic rolled across America this spring, some 20 states acted to protect nursing homes instead of patients. Incredibly, these states approved broad immunities for healthcare facilities. New York States’ immunity measure kicked in on March 6th. It’s no wonder they had some of the highest nursing home death rates in the nation.
There is no incentive to protect elderly and medically vulnerable residents if the facility knows it can’t be sued. There was such an outcry in New York that earlier this month the state partially repealed their nursing home immunity measure. Unfortunately, the repeal isn’t retroactive. We can’t bring those who have needlessly died.
A Second Wave of Nursing Home Deaths?
The Centers for Medicare and Medicaid Services (CMS) are sounding the alarm about another wave of nursing home infections. So is MedPage Today.
According to CMS Administrator Seema Verma, the number of virus cases in nursing homes in early spring was about 11,000 a week. By the end of June that number dropped to 6,300 per week. Now in mid-August the number of weekly cases in nursing homes is at an all-time high, 12,000 cases per week.
Even though several new promising treatments have been rolled out, Verma says that “losses” are still increasing. Loss is bureaucratic speak for death.
"This is not just a testing issue or a supply issue”, said Verna. “Our deep concern is that even in nursing homes that are doing testing on a regular basis, we are still seeing significant spread." She also said that one cases in a home could spread to half the residents “in a matter of hours.”
Why the sudden increases?
Knowing what we know about the nursing home industry, there are several answers. First, infection control practices at many nursing homes are abysmal. Second, the nursing home lobby has pressured about half the states to give immunity to nursing homes.
The immunity issue is complex. You can read more on our coronavirus nursing home immunity page. Basically, twenty states have absolved nursing homes of any responsibility for their own negligence. It’s hard to believe that their lobbyists are that powerful. AARP has been fighting the good fight for patient rights but we are not winning the battle.
CMS and the states have performed almost 17,000 focused infection control inspections in recent months. Only 2% found problems. Yet today Verma says that half of our nursing homes have had reported coronavirus cases.
If that happened in the community, there could be a lot of finger pointing as to who was responsible for the spike in cases. In a nursing home, it is ridiculous to think that the residents are going out to crowded bars and bringing back the virus, however. Their inspection data simply isn’t believable.
Medicare says this year deficiencies for infection control are up 300%. We think it’s more likely that inspectors are no longer willing to look the other way.
Now CMS is suddenly trying to make up for lost time. Recently the agency reported it fined 3,400 nursing homes more than $15.5 million for either infection control violations or not properly alerting authorities to COVID-19 outbreaks.
We won’t say their efforts are too little but they are too late for thousands of nursing homes residents who needlessly died horrible deaths.In a meeting with nursing home administrators on August 20th, Verma said that as America reopens, CMS will “continue to urge states and governors to fight fiercely for nursing home residents, to vigilantly oversee facilities, and to fulfill the needs of nursing homes as it relates to testing and other needed supplies.” We hope so.
Recent CMS Coronavirus Initiatives
- February 6 - CMS took action to prepare the nation’s healthcare facilities for the COVID-19 threat.
- March 4 - CMS issued new guidance related to the screening of entrants into nursing homes.
- March 10 - CMS issued guidance related to the use of personal protective equipment (PPE).
- March 13 - CMS issued guidance for a nationwide restriction on nonessential medical staff and all visitors.
- March 20 - CMS announced a suspension of routine inspections, and an exclusive focus on immediate jeopardy situations and infection control inspections.
- March 30- CMS announced that hospitals, laboratories, and other entities can perform tests for COVID-19 on people at home and in other community-based settings outside of the hospital – including nursing homes.
- April 2- CMS issued a call to action for nursing homes and state and local governments reinforcing infection control responsibilities and urging leaders to work closely with nursing homes on access to testing and PPE.
- April 15 - CMS announced the agency will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases.
- April 19- CMS announced it will require nursing homes to report cases of COVID-19 to all residents and their families, as well as directly to the CDC.
- On April 30, 2020, CMS codified this guidance.
- May 6 - CMS issued guidance in an Interim Final rule that updates reporting requirements for nursing homes to notify confirmed and suspected COVID-19 cases among residents and staff.
- May 18 - CMS issued guidance for state and local officials on the reopening of nursing homes.
- June 1 - CMS issued guidance to states on COVID-19 survey activities, CARES Act funding, enhanced enforcement for infection control deficiencies, and quality improvement activities in nursing homes. CMS also issued a letter to governors.
- June 4 - CMS posted first set of underlying COVID-19 nursing home data and results from targeted inspections conducted by the agency since March 4, 2020 linked on Nursing Home Compare.
- June 19 - CMS announced membership of Independent Coronavirus Commission on Safety and Quality in nursing homes
- June 23, 2020 - CMS released FAQs on nursing home visitation.
- July 10, 2020 - CMS announced it will deploy Quality Improvement Organizations (QIOs) across the country to provide immediate assistance to nursing homes in hotspot areas.
- July 14, 2020 - HHS and CMS announced initiative for rapid point-of-care diagnostic devices and tests in nursing homes.
- July 22, 2020 - CMS announced several new initiatives designed to protect nursing home residents from COVID-19, including new funding, enhanced testing and additional technical assistance and support.
- 7, 2020 - HHS announced the distribution of $5 billion in Provider Relief Funds, consistent with the Administration’s announcement in late July, which will be used to protect residents of nursing homes and long-term care facilities from the impact of COVID-19.
- 12, 2020 - CMS released nursing home enforcement actions during pandemic.
While we are certainly supportive of the efforts of CMS and its state partners, a third factor in the burgeoning coronavirus nursing home crisis is the lack of adequate staffing, pay and training. To work in most nursing homes today you need to be a saint.
We aren’t discrediting the women and men that work on the front lines in nursing homes. The fault lies with administrators who become more focused on profits and instead of patients. They alone have the power to increase training and pay, purchase personal protective equipment and provide adequate staffing.
A Kaiser Family Foundation study found that 1 in 3 nursing homes lacked proper staff and / or PPE. That is not a god way to prevent a coronavirus outbreak within a home. Until August 14th, CMS gave nursing homes a temporary break on reporting staff levels. While we understand that in the early stages of the pandemic nursing homes didn’t have time to shuffle papers, those statistics and reports were important for families trying to make a placement decision for a loved one.
Did a Loved One Die in a Nursing Home of Coronavirus?
If you lost a family member recently because of coronavirus, our thoughts and prayers are with you. Our national team and network of nursing home neglect lawyers at Mahany Law are actively investigating these deaths that occurred in nursing homes. Although we probably can’t do anything in states that have given immunity to negligent nursing homes, we are once again considering New York cases and cases in 29 other states.
For more information visit our cornerstone content on coronavirus nursing home deaths. Ready to see if you have a case? Contact us online, by email [hidden email] or by phone 833-201-1555. (Cases accepted nationwide - we have lawyers throughout the United States.)