Whitehouse Pushes for COVID-19 Senate Proposal to Protect Residents, Employees

Published in the Pawtucket Times on March 1, 2021

As the one-year anniversary of the coronavirus disease (COVID-19) pandemic approaches, U.S Senator Sheldon Whitehouse (D-RI) joins Senators Bob Casey (D-PA), Raphael Warnock (D-GA), Richard Blumenthal (D-CT), and Cory Booker (D-NJ) in introducing a legislative proposal to save lives of nursing home residents and employees and assist with vaccinations.   At press time, over 1.3 million nursing residents and workers in long-term care facilities have been infected with COVID-19 and more than 170,000 have died so far, accounting for approximately 35 percent of COVID-19 deaths nationwide.

Taking a Close Look at S.333

Last week, S.333, “The COVID-19 Nursing Home Protection Act,” was thrown into the legislative hopper.  Initially introduced last Congress, the latest version, now being considered by the Senate Finance Committee, would provide funding to give nursing homes the needed resources to keep residents and workers safe; funding would go towards providing vital infection control assistance and organizing local health and emergency workers – known as “strike” or “surge” teams – to manage COVID-19 outbreaks and care for residents.  At this time no House companion measure has been introduced.

S. 333, introduced on Feb. 22, would provide $210 million for the Secretary of HHS to contract with quality improvement organizations to provide essential infection control assistance to nursing homes. 

Moreover, the legislative proposal would also send $750 million in funding to states to implement “strike” or “surge” teams. States are using “strike” or “surge” teams to ensure a sufficient number of aides, nurses and other providers are available to care for residents. Such teams also help manage COVID-19 outbreaks within a facility, particularly as vaccinations proceed in these settings. Since August, approximately 20 percent of nursing homes have reported each week that they do not have a sufficient workforce to care for residents.”

The impact of the pandemic has been devastating to minority communities, where reports have indicated that facilities serving significant numbers of Black and Hispanic residents were twice as likely to have COVID-19 infections. S. 333 would require the HHS Secretary to collect and make public demographic data on COVID-19 cases and deaths, including information on age, race, ethnicity, and preferred language. 

Whitehouse supports President Joe Biden’s call for the implementation of strike teams in his American Rescue Plan to help address these persistent shortages as well as the collection and dissemination of data on suspected and confirmed COVID-19 cases and deaths by race, ethnicity and preferred language.

Controlling COVID-19 Outbreaks in the Nation’s Nursing Homes

“Nursing home residents and staff have been through a traumatic year,” said Whitehouse who sites on the Senate Finance Committee.  “We need to prioritize vaccinating and caring for the Americans who live and work in these settings.  That means providing additional staff as needed to control outbreaks and making sure every resident and care worker who wants a vaccine can get one.,” said the Rhode Island’s junior Senator who has served since Jan. 4, 2007.

“As more than 170,000 residents and workers in nursing homes and other long-term care facilities have died from COVID-19, it is critical that Congress pass the COVID-19 Nursing Home Protection Act,” says Sen. Bob Casey, Chair of the U.S. Special Committee on Aging.

“This bill would address persistent staffing shortages in nursing homes by utilizing strike teams, promote infection control protocols and require that demographic data is collected on COVID-19 cases and deaths,” notes Casey.

Adds Casey, “The challenge this terrible virus poses are unprecedented and requires an immediate and extraordinary response. That is why my colleagues and I are advancing strategies to give states what they need – funding for ‘strike’ teams to help address staffing shortages in nursing homes and assist with vaccinations in these settings. We have an obligation to protect our most at-risk citizens.”

 “We applaud the efforts of Senator Whitehouse and his colleagues to provide funding for the protection of nursing home residents and staff,” said Scott Fraser, President and CEO of the Rhode Island Health Care Association, an affiliate of the Washington, DC-based American Health Care Association.  “We are especially pleased with the creation of strike teams to address the critical issue of staffing shortages during times of crisis.  This is a suggestion that RIHCA brought to Senator Whitehouse’s attention this past Spring when our homes were in critical need of additional staff due to the pandemic.  We thank him for listening and taking action,” he says.

At press time, 12 Democratic Senators join Sens. Whitehouse, Casey, Warnock, Blumenthal, and Booker, becoming cosponsors to this legislation.  They are: Sens. Maria Cantwell (D-WA), Bob Menendez (D-NJ), Jeanne Shaheen (D-NH), Tina Smith (D-MN), Amy Klobuchar (D-MN), Tammy Duckworth (D-IL), Chris Van Hollen (D-MD), Sherrod Brown (D-OH), Catherine Cortez Masto (D-NV), Jack Reed (D-RI), Maggie Hassan (D-NH) and Mazie Hirono (D-HI). 

A Call for Bipartisan Support

With the Senate now under Democratic control, there is a good chance that S. 333 will be considered by the Senate Finance Committee and if passed sent to the floor for consideration.   During the 116th Congressional session, the former Senate GOP Majority Leader, Mitch McConnell, of Kentucky, who often called himself the “Grim Reaper,” sent Democratic legislation to a legislative graveyard, refusing to act on Democratic legislation, even proposals with bipartisan support.

It’s time for Senate Republicans to support a Democratic proposal that protects the health and safety and the wellbeing of nursing home residents and workers in the nation’s 15,600 nursing homes. 

Partisan politics shouldn’t play a role in Senate Minority Leader Mitch McConnell’s decision to not urge his caucus to support this worthy legislative proposal.  S. 333 truly deserves bipartisan support and enactment, especially during the ongoing COVID-19 pandemic.

Dr. Teresa Chopoorian: McKnight’s Women of Distinction Award winner

Published in the Pawtucket Times on February 22, 2021

After reviewing hundreds of submitted entries, an independent panel, composed of two dozen judges, selected 19 women, including Dr. Teresa J. Chopoorian, to be inducted into the McKnight’s Women of Distinction Hall of Honor as part of the program’s third annual class. 

Dr. Chopoorian serves as Vice President and Administrator of the Central Falls, RI-based Mansion Nursing and Rehabilitation Center and is a former Professor of Nursing and Chairs the City of Pawtucket Cancer Control Task Force.     

According to McKnight’s Long-Term Care News the Hall of Honor recognizes executive-level professionals who have made a significant impact in the skilled nursing or senior living industries.  Of the sixty women who have been inducted into the Distinction Hall of Honor since its inception in 2019, Dr. Chopoorian is the only Rhode Islander to receive this prestigious recognition. 

Considered the hallmark of recognition for women leaders in the seniors’ care and living industries, McKnight’s Women of Distinction honors are given in three categories: Rising Stars, Veteran VIPs, and the Hall of Honor. A Lifetime Achievement Award winner will also be announced in March.  The annual awards program is administered jointly by McKnight’s Long-Term Care News and McKnight’s Senior Living. The winners will be recognized in editions of the McKnight’s Daily Update and McKnight’s Daily Briefing newsletters.

All of this year’s honorees, working in the health care industry, will be celebrated during a May 18th virtual awards event.  The ceremony will take place the evening followed by a special McKnight’s educational forum for all professionals in the long-term care and senior living industries the next morning. 

The Life and Times of Dr. Chopoorian

Dr. Chopoorian was hired as an Instructor at Boston University School of Nursing after completing her master’s degree at this university in 1964.  She was promoted to Assistant Professor and recognized as Teacher of the Year in 1968.  

She left Boston University in 1970 to accept a professorship at Boston College to co-direct a Macy Foundation graduate program with Harvard Medical School, a novel initiative to prepare Clinical Nurse Specialists. The program was among the first graduate nursing curriculum in the country and served as a critical role model for forthcoming nurse practitioner programs. 

In 1974, Dr. Chopoorian joined the faculty of Boston State College Department of Nursing and began doctoral studies at Boston University in 1978.  Upon completion of her doctorate in 1982, she accepted a professorship at Northeastern University School of Nursing where she continued to teach and participate in the development of nursing practice.

Coming Back Home to Long Term Care

Dr. Chopoorian joined the Mansion after a 22-year career as a nursing educator.  Her career parallels the transformation of nursing home care as it has undergone generational change.  As nursing homes evolved from custodial care to a case mix of higher morbidities and a greater need to deal with an increasing population of younger residents and residents with mental illnesses, Dr Chopoorian’s career paralleled this transformation in unique ways.

Starting as a teenager working in her family’s business, a 76-bed nursing home on the border of Central Falls and Pawtucket, mill towns emerging from the flight of the textile industry, she was inspired to become a nurse.  She then chose the rigor of enrolling at Classical High School Providence, which laid a strong foundation of scholarship that would serve her well.   More importantly, this earliest choice illustrated a characteristic of always taking on the greater challenge.  

In 1986, Dr. Chopoorian joined the Mansion staff at a time of family crisis.  Her father was retiring as administrator soon after the passing of her mother. At a crossroad of whether to continue the development of a fruitful academic career or apply her clinical knowledge and nursing skills to a family business, she made the critical choice of leading the family’s nursing facility while caring for her father. A daunting choice on every level, leaving the security of an academic career for a business whose nature and regulatory landscape were dramatically different than two decades earlier when she helped her father as a nursing aide.   

Dr. Chopoorian’s family crisis thrust her into the role of Administrator; she led the Mansion as a quality provider of skilled care and rehabilitation services, consistently a 4 and 5-star rated facility.  In 2010, she was recognized as the first recipient of the Nightingale Nurse of the Year Award by the Rhode Island State Nurses Association, as a nurse in the role of nursing home administrator.

Dr. Chopoorian also became active in the greater community and participated in boards such as the Pawtucket YMCA and Samaritans of Rhode Island. But closest to her heart, she has a lifelong commitment to cancer prevention, and has become one of the strongest local voices for cancer prevention in her community.  As chair of the Cancer Control Task Force supported by the City of Pawtucket Mayor’s office, she instituted programs such as a Poetry Slam that has young local school students writing poems competitively on the theme of smoking cessation or prevention.

A Rising Star in the Nursing Profession 

After graduation from the College of Nursing at the University of Rhode Island in 1962, she started as a Staff Nurse at Children’s Hospital Medical Center in Boston. Again, rising to the greater challenge, she enrolled in the Nursing Master’s program at Boston University.  It launched a career that would keep her in the mainstream of nursing education and growth, up to the present day to bring her full cycle to administering a family business and the challenges of passing it on to a third generation.

Dr. Chopoorian shared her pioneering work on education for nursing practice through her teaching, publishing and consulting as these programs became established. She was recognized for her work by the Massachusetts Nurses Association in 1974 – “Recognition of a Nurse Influencing the Directions of Professional Nursing Practice”. 

Perhaps the most prestigious recognition was her selection as the 9th recipient of the International Council of Nursing (ICN) Fellowship in 1978, the first US candidate to be selected from among its 44 member countries.

Among Dr. Chopoorian’s publications, one of special note is her article, “Reconceptualizing the Environment”, which called attention to the social, cultural, political and economic environmental factors that impact the practice of nursing. Published in 1986, it is still heavily cited by scholars in the field and pertinent to the dialog of nursing practice today.

She was appointed Fellow in the National Academy of Practice, Nursing in 1987.

Meeting the Challenges of COVID-19

Dr. Chopoorian is now practicing what she has preached over the years, applying her knowledge and skills to the practical matters of administering a skilled nursing care facility, and doing it in a manner that has earned her the recognition of her peers as Nightingale Nurse of the Year.

Early in March 2020 as it became clear that nursing homes were ground zero in an epic battle; she consulted with her Medical and Nursing Director and decided to close admission of anyone into the facility who was not already in the facility until October of 2020, when community spread overcame the facility staff’s most resolute of defenses. The Mansion is one of only three facilities in Rhode Island with this record in the midst of what was designated as the state’s hot zone. The residents and staff who tested positive have since quickly passed quarantine with no deaths or illnesses. A major practice achievement as we now head into a time of protection with the Pfizer, Moderna, and other versions of the COVID-19 vaccine, and are hopefully home free.

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.