AARP Rhode Island Shows RI Facilities Remain Hotbed for COVID-19

Published in RINewsToday on February 14, 2021

As the Rhode Island Health Department (RIDOH) announces that cases of COVID-19 are declining and is loosening up restrictions on the reopening of bars and our social gatherings, AARP Rhode Island warns that the state’s nursing homes remain a hotbed for COVID-19 infections, and the “death rate remains disturbing.”  Rhode Island’s largest aging advocacy group calls on the General Assembly to take action this session to enact legislation to protect facility staff and residents. 

Since the beginning of the pandemic, more than 162,000 residents and staff in nursing homes and other long-term care facilities have died nationwide, and nearly 1.3 million people are known to have been infected with coronavirus in these facilities. Rhode Island has recorded 1,430 deaths in skilled nursing facilities, nursing homes, assisted living facilities and other eldercare facilities.
On Feb. 11, AARP Rhode Island released its Nursing Home COVID-19 Dashboard, the data revealing that the COVID-19 pandemic crisis in these facilities still continues despite incremental improvements in all four dashboard categories.

The dashboard analyzes federally reported data in four-week periods going back to June 1, 2020. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the dashboard to provide snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.

Taking a Snapshot 

According to the data (Dec. 21 to Jan. 17) from AARP Rhode Island’s latest Nursing Home COVID-19 Dashboard, the rate of new coronavirus cases per 100 residents declined from 15.7 to 10.6 among residents and from 12.5 to 10.6 among staff. While cases are lower than in the previous time period, resident cases remain the second highest in New England in AARP’s dashboard analysis, with nearly four times the cases in Rhode Island nursing homes reported in October and November.

Meanwhile, the latest dashboard data indicated that resident death rates dropped from 2.60 to 1.82 for every 100 people living in a nursing home and that nursing home staff cases dropped from 12.5 per 100 workers to 10.6.The dashboard also reveals that PPE shortages dropped sharply. Shortages of personal protective equipment (PPE) have declined from 20.3 percent of nursing homes without a one-week supply to 4.3 percent — the lowest number since the first dashboard report in June, 2020. Staff shortages were relatively steady, dropping from 41.9 percent of facilities reporting shortages to 40 percent.

AARP Rhode Island calls on Governor Gina Raimondo and Lt. Governor Dan McKee to protect nursing home residents and staff from COVID-19. “We are approaching the one-year anniversary of the first known coronavirus cases in nursing homes, yet they remain appallingly high, said AARP Rhode Island State Director Kathleen Connell in a statement announcing the release of the latest dash data said, “The devastation this pandemic has brought to nursing home residents and their families has exposed fundamental reforms that must be made in nursing homes and to the long-term care system. We cannot lower our guard, she says.

AARP Rhode Island’s COVID-19 Legislative Agenda

The Rhode Island nursing home industry has struggled with quality care and infection control for years. Connell called for Rhode Island lawmakers to act immediately, focusing this year on: 

1.   Enacting or making permanent the components of AARP’s five-point plan:·         

— Prioritizing regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff—as well as for inspectors and any visitors.·  

—  Improving transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.·         

— Ensuring access to in-person visitation following federal and state guidelines for safety, and require continued access to virtual visitation for all residents.·        

—  Ensuring quality care for residents through adequate staffing, oversight, and access to in-person formal advocates, called long-term care Ombudsmen.

2.      Reject immunity and hold long-term care facilities accountable when they fail to provide adequate care to residents.

3.      Establishing minimum nursing staffing standards.

4.      Ensuring that increases in facility’s reimbursement rates are spent on staff pay and to improve protections for residents.

5.      Ensuring progress is made so that in-person visitation can safely occur and facilitating virtual visitation.

“Additionally, our leaders must reject policies that take away the rights of residents to hold nursing homes accountable when they fail to provide adequate care, Connell added. “Now is not the time to let nursing homes off the hook for abuse, neglect, and even death.”  AARP Rhode Island wrote a letter to Gov. Raimondo, urging her to withdraw her nursing home immunity Executive Order.  At press time, there has been no reply.

As the first year of the COVID-19 pandemic approaches, RIDOH notes that 64 percent of all deaths have women and men in Rhode Island’s nursing homes and assisted living facilities. In the past 13 days, 116 new cases in these facilities have been diagnosed – with 41 new deaths. At weekly updates from Dr. Nicole Alexander-Scott, it used to be that the death statistics were broken down by age, noting how many were lost “in their 60s, in their 70s”, etc. but notably this no longer is reason for pause and expression on condolence.

Unless Rhode Island lawmakers act quickly, older Rhode Islanders in these facilities will continue to be at a very high-risk of catching COVID-19 and the fatality death rate will remain disproportionately high for seniors. As residents receive their vaccine shots, first and second, we in turn hope that the refusal rate of staff to the vaccination is going down.

It’s time to act. 

The full Nursing Home COVID-19 Dashboard is available at  www.aarp.org/nursinghomedashboard.  

For more information on how COVID is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes.

AARP’s new COVID-19 Dashboard for national/local Nursing Home Data

Published in RINewsToday.com on October 26, 2020

While public health experts are predicting a second spike of the COVID-19 virus, expecting it to hit the nation as early as – now – and reaching its peak in December, AARP releases its Nursing Home COVID-19 Dashboard created to provide four-week snapshots detailing the infiltration of the virus into the nation’s nursing homes and its impact on residents and staff.  AARP’s latest Public Policy Institute analysis is the result of the Washington, DC-based aging advocacy group’s successful efforts to push for the public reporting of nursing home COVID-19 cases and deaths.

Using data collected by the Centers for Medicare & Medicaid Services—which is self-reported by nursing homes—the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard to provide four-week snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff. The first release of the dashboard on October 14 reveals that nursing homes in every state reported shortages of PPE, ranging from 8 percent of facilities in the best-performing states, to 60 percent in the lowest-performing state. The dashboard also compared state and national data on COVID-19 cases and deaths, staff cases and staffing shortages.

Key Findings of AARP’s First Dashboard

The AARP Public Policy Institute will analyze data and report on key findings as the dashboard is updated over time.  Here are some observations about AARP’s first Dashboard (using data from August 24 to September 20, in which 95 percent of the nation’s 15,366 nursing homes submitted data for this time period):

According to the database, in every state, nursing homes indicated a shortage of PPE (defined as not having a one-week supply of N95 masks, surgical masks, gowns, gloves and eye protection during the previous four weeks). Nationally, about one quarter (25.5 percent) of nursing homes had a PPE shortage during the Aug. 24 to Sept. 20 reporting period. In the highest performing state, 8 percent of nursing homes had a PPE shortage; in the lowest-performing state, 60 percent did not have a one-week supply.

The researchers note that while considerable attention has been paid to infections among nursing home residents, it is also critically important to consider direct-care staff. In the four weeks ending Sept. 20, one-quarter (24 percent) of nursing homes had at least one confirmed COVID-19 case among residents, and twice as many (50 percent) had at least one confirmed staff case. Per 100 nursing home residents, there were 2.6 COVID-19 resident cases and 2.5 staff cases, corresponding to a total of about 55,000 cases nationally.

Finally, there is considerable variation across states. COVID-19 deaths in the four weeks ending Sept. 20 averaged 0.5 per 100 residents across the nation (about 1 out of every 200 residents). At the state level, the death rate was as high as 1.2 per 100 residents (about 1 out of 80), and several states reported no resident deaths in the past month.

Looking at Rhode Island, AARP’s first dashboard detailed the following: 

·         2.2 COVID cases per 100 residents

·         0.2 COVID deaths per 100 residents

·         1.7 staff cases per 100 residents

·         19.7 percent of nursing homes without a 1-week supply of PPE

·         28.9 percent of nursing homes with staffing shortages

AARP’s dashboard will be updated every four weeks to track trends over time and will evolve to include more categories to follow other measures of interest.

As Others See It – in Rhode Island

“We have been very clear in our messaging: No state has done a good enough job to protect nursing home residents and staff,” said AARP Rhode Island State Director Kathleen Connell. “That said, it is good to see that in the first round of data postings on the AARP Nursing Home COVID Dashboard shows Rhode Island in better-than average shape compared to other states. But to our point, anyone in Rhode Island with a loved one in a nursing home expects – hopes and prays – for more than ‘better than average.”

“As we see daily reports of increased cases and deaths, safety concerns for nursing home residents and staff should be increasing as well. The pandemic is far from over and among many complicated aspects of dealing with it is transparency. The COVD Dashboard provides the public with a benchmark and tracks monthly changes; people need to pay attention and demand action at all levels to make nursing homes safer. These aren’t just numbers. These are lives,” says Connell.

On the other hand, the Rhode Island Department of Health questions the accuracy of AARP Nursing Home COVID-19 Dashboard as it relates to its Rhode Island findings. “The data don’t accurately reflect the Rhode Island reality in part because of how the questions are phrased,” says Joseph Wendelken, RIDOH’s Public Information Officer, specifically related to PPE data. “The question asks about PPE in the nursing homes. Nursing homes receive a weekly supply of PPE from their corporate warehouses. The question asks about one point in time. On occasion, reporting happens shortly before facilities receive their re-supply,” he says.

“RIDOH has taken several steps to protect nursing home residents, says Wendelken, noting that his department has built Congregate Setting Support Teams to conduct targeted to facilities regarding infection control, PPE, testing, and staffing. 

“We have weekly contact with facilities. We’ve worked with facilities to develop creative plans for reopening. We have implemented regular testing of staff every 10 to 14 days. We will take the lessons and experience we’ve gained from these past seven months and apply them to the increase in cases we see today,” adds Wendelken. 

According to Scott Fraser, President/CEO, of the Rhode Island Health Care Association (RIHCA), the AARP analysis shows what his organization has been saying in the last few weeks and months—that COVID-19 cases in nursing homes continue to drop. “Rhode Island is below the national average in all categories measured for this dashboard,” he says, stressing that the number of cases in nursing homes is dropping as is the number of deaths,” notes Fraser.  

The successful efforts to protect nursing home residents and staff can be directly linked to the measures the facilities have taken since the pandemic first hit, notes Fraser. “We are stocking up on PPE. We initially suspended visitation.  We are testing staff regularly and residents when necessary.  We are carefully monitoring visitors and vendors who come into our homes.  We isolate and quarantine anyone who tests positive or any new resident who moves into our facilities,” he says. 

Fraser says that RIHCA continues to advocate for regular testing of vendors who come into the state’s nursing homes, including ambulance drivers, lab technicians, and hospice workers.  RIHCA continues to call on RIDOH to renew the policy of having two negative tests before a hospital patient can be released to a nursing home and to allow those certified nursing assistants who received temporary emergency certifications to obtain their permanent licenses.

A Call to Action

More than 84,000 residents and staff of nursing homes and other long-term care facilities have died from COVID-19, representing 40 percent of all coronavirus fatalities in the U.S., according to Kaiser Family Foundation’s most recent analysis released on Oct. 8. Yet in its statement announcing the release of its Dashboard, AARP charges that federal policymakers have been slow to respond to this crisis, and no state has done a good enough job to stem the loss of life. 

According to AARP, policymakers have taken some action, such as requiring nursing homes to self-report COVID-19 casers and deaths at the federal level, ordering testing, and providing limited PPE and other resources to nursing homes. But more must be done, says the nation’s largest aging advocacy group in its statement urging elected officials “to acknowledge and take action to resolve this national tragedy — and to ensure that public funds provided to nursing homes and other long-term care facilities are used for testing, PPE, staffing, virtual visits and for the health and safety of residents.”

COVID-19 cases across the U.S. are again on the rise, and nursing homes remain a hotbed for the virus, says AARP promising to “continue to shine a light on what’s happening in nursing homes so that families have the information they need to make decisions, and lawmakers can be held accountable.”

AARP has called for the enactment of the following five-point plan to protect nursing home and long-term care facility residents — and save lives — at the federal and state levels:

·         Prioritize regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff — as well as inspectors and any visitors.

·         Improve transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.

·         Require access to facilitated virtual visitation, and establish timelines, milestones and accountability for facilities to provide in-person visitation.

·         Ensure quality care for residents through adequate staffing, oversight and access to in-person formal advocates, called long-term care ombudsmen.

·         Reject immunity for long-term care facilities related to COVID-19.

To see AARP Nursing Home COVID 19 Dashboard, go to:

www.aarp.org/content/dam/aarp/ppi/pdf/2020/10/rhodeisland-nursing-home-dashboard-october-2020-aarp.pdf

Tele-Town Hall Gets the Word Out About COVID-19

Published in Woonsocket Call on May 3, 2020

This week alone, AARP in some 30 states conducted tele-town halls and 123 state calls have taken place since the pandemic surfaced. AARP Rhode Island, representing 132,000 members age 50 and over, was among the very first states to address the pandemic in a tele-town hall over two weeks ago.

At the AARP Tele-Town Hall, held Wednesday, April 22, during the 56-minute live event, state officials came to answer questions about how to cope with the devastating COVID-19 pandemic and how seniors can protect their health and stay safe. AARP Rhode Island’s John Martin, Communication Director, served as host and the panel of experts featured Office of Healthy Aging (OHA) Director Rosamaria Amoros Jones and Rhode Island Department of Health Medical Director Jim McDonald.

“We had 3,050 participants and, at one time, 974 people were on at the same time,” says Martin, who hosted the call. “We took 18 live calls in 55 minutes and, unfortunately had close to 20 people waiting to speak when time expired,” he adds, noting that it was AARP Rhode Island’s largest tele-town hall audience ever.

According to Martin, “Our in-call interactive poll revealed that nearly three quarters of those who cast votes were most interested in local resources and information on how to prevent the spread of the coronavirus, About a quarter said they were looking for help caring for family and loved ones, and information on insurance.”

Adds AARP State Director Kathleen Connell, “We were extraordinary pleased with the response to the tele-town hall,” who said she expects more statewide calls. “Just as important, however, is our virtual engagement with members and especially our volunteers. We are getting used to communicating online because that is where all of our ‘personal’ contact will be taking place, at least in the next few months — and that will include video conferencing, which we are testing now. We are impressed at how eager people 50 and older are ready to master the technology and join in.”

State Officials Talk COVID-19

“We are at a point where we are starting to see the benefits of our collective efforts of [maintaining] physical distancing, states OHA Director Jones. It is flattening the curb where the peak number of people requiring care at a time is reduced and the health care system is not overwhelmed, she says.

“It is really important for us that social or physical distancing as we also refer to it does not equal social isolation,” says Jones, noting that innovative approaches can keep people engaged with each other during this time of physical distancing.

Jones also gave a plug for Project Hello (http://oha.ri.gov/get-involved/volunteering/), a program that matches older adults with someone in the community for regular chats and for mutual support. “We’re in it for the long haul and it is going to take all of us working together neighbors helping neighbors,” she says.

“Effective quarantine and isolation efforts are critical today,” says Jones. “Our focus is on making it as easy and as comfortable as possible right now to stay home as we ready ourselves for the new normal that is on the other side of the pandemic,” she adds.

Jones called for those in quarantine and self-isolation reach out to Shopping Angels (www.facebook.com/shoppingangelsinc/) for assistance in personal shopping.

One caller expressed strong concern about Governor Gina Raimondo’s comment that people over age 60, at greater risk of severe COVID-19 illness, would be required to stay home for a longer period of time before being allowed to return to work or participate in community activities. “There have been no definitive decisions to implement restrictions at this time,” said Jones trying to reassure the caller.

Although there are programs and services detailed on the internet that can assist older Rhode Islanders to cope with the COVID-19 pandemic, one caller asked how these could be accessed without a laptop, computer or smart phone. Jones noted that The Point (http://oha.ri.gov/get-help/), operated by United Way Rhode Island and linked through 211 or by dialing (401) 462-4444, could provide information, referrals to needed programs and services.

How would people age 60 and over be protected against age discrimination when the governor is stating that it might take a longer time for these individuals to return to work? asked a caller. “It’s something we are thinking a lot about and a lot more [will] come as we talk about what the new normal is going to look like as we come through the peak of the pandemic, says Jones, stressing that age discrimination would not be tolerated.

Jones called for listeners to visit NextDoor.com, a website that promotes volunteer opportunities (including the delivery of groceries for seniors and those in quarantine), to see how they could help those impacted by COVID-19. For those seeking information about housing, Jones recommended a site, RI Havens, that provides a listing of hotels with affordable room rates for front line workers and for those persons stranded because of the virus and might need a safe place to stay. Details about food delivery options and food assistance programs can be found at the site, RI Delivers, that connects those in quarantine or isolation due to COVID-19 with opportunities to have food delivered by local and big-box grocery stores.

One caller asked Dr. James McDonald, Medical Director at RI Department of Health (DOH), about how a person could improve their immunity to assist them to successfully combat COVID-19. “You can’t always control the virus but you can control yourself,” says McDonald, stressing the importance of eating a healthy diet, regularly exercising and losing weight are actions to take to improving your health.

Making COVID-19 Transparent in Rhode Island’s Nursing Homes

During the Tele-Town Hall, McDonald was asked a question, “Why can’t the Health Department provide a list of long-term care and assisted living facilities that will show the number of patients/residents who have tested positive for COVID-19 and the number of facilities.” Twenty-four hours later this list appeared on the DOH Coronavirus Data Hub. (https://ri-department-of-health-covid-19-data-rihealth.hub.arcgis.com/).

McDonald noted that this particular virus has been so effective in causing the pandemic because it takes so long for a person to show symptoms and that other people who have it sometimes spread the virus before they even have symptoms and they don’t even know they should isolate because they don’t feel ill. It becomes important for a person to wear a mask when going outside to stop the spread of the virus, he says.

MacDonald says that it is highly unlikely to catch COVID-19 by touching grocery bags placed on your porch or through picking up a letter or package. He suggests constantly using hand sanitizer and washing your hands before and after picking up items touched by others.

AARP has created a special web page, http://www.aarp.org/RICOVID for coronavirus information and resources,” says AARP Rhode Island’s Martin added. “There you will find information about our ‘Community Connections’ program, aimed at combating isolation and loneliness, and a direct link to http://www.aarp.org/coronovirus, where all of AARP’s resources can be found.