It’s time. Staff vaccinations required for nursing homes as 10 RI facilities see new COVID cases

Published in Rhode Island News Today on August 24, 2021

With the COVID-19 Delta variant spiking across the country especially among the unvaccinated, last Wednesday, President Joe Biden announced at an afternoon address at the White House that the U.S. Department of Health and Human Services will require nursing homes to require all workers to be fully vaccinated against COVID-19 as a condition for those facilities to continue receiving federal Medicare and Medicaid funding.

According to federal data, of the 1.6 million nursing home workers across the  nation, about 540,000 — 40 percent of the work force — are unvaccinated.  

Since the spread of the Delta variant, there has been a rise in the number of COVID-19 cases, especially in those states that have low rates of vaccinated workers. Both the U.S. Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) data confirm a strong relationship between the increase of COVID-19 cases among nursing home residents and the rate of vaccination among nursing home workers.

These new emergency federal regulations, crafted  by CDC and CMS, would apply to nearly 15,000 nursing home facilities, which employ approximately 1.6 million workers and serve approximately 1.3 million nursing home residents.

Rhode Island Gov. Dan J. McKee, along with other states, has already taken a similar step to protect nursing home residents by requiring all staff to be vaccinated and the new federal mandate will ensure consistent and equitable standards throughout the country. 

At a COVID-19 update held at the state the state capitol in early August, McKee called for the new vaccine mandate (as a term of employment) to take effect on Oct. 1st.

On August 23rd, Pfizer’s vaccine was fully approved by the FDA. Approvals of Moderna, Johnson & Johnson and booster shots are expected to follow soon.

According to CMS, the new mandate is a key component of protecting the health and safety of nursing home residents and staff by ensuring that all nursing home staff receive COVID-19 vaccinations. Over the past several months, millions of vaccinations have been administered to nursing home residents and staff, and these vaccines have shown to help prevent COVID-19 and have proven to be effective against the Delta variant.

“Keeping nursing home residents and staff safe is our priority. The data are clear that higher levels of staff vaccination are linked to fewer outbreaks among residents, many of whom are at an increased risk of infection, hospitalization, or death,” said CMS Administrator Chiquita Brooks-LaSure in a statement announcing the new vaccine mandate.  “We will continue to work closely with our partners at the CDC, long-term care associations, unions, and other stakeholders to advance policies that keep residents and staff safe. As we advance these new requirements, we’ll work with nursing homes to address staff and resident concerns with compassion and by following the science,” she said.

CMS says that it’s requiring all nursing home staff to be vaccinated is in keeping with the federal agency’s authority to establish requirements to ensure the health and safety of individuals receiving care from all providers and suppliers participating in the Medicare and Medicaid programs. About 62% of nursing home staff are currently vaccinated as of August 8 nationally, and vaccination among staff at the state level ranges from a high of 88% to a low of 44%. The emergence of the Delta variant in the United States has driven a rise in cases among nursing home residents from a low of 319 cases on June 27, to 2,696 cases on August 8, with many of the recent outbreaks occurring in facilities located in areas of the United States with the lowest staff vaccination rates.

Last May, CMS issued new regulations that require Long-Term Care (LTC) facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) to educate residents, clients, and staff about COVID-19 vaccination and, when available, offer a COVID-19 vaccine to these individuals. These regulations also mandate that LTC facilities report weekly COVID-19 vaccination data for residents and staff to the CDC’s National Healthcare Safety Network (NHSN).

CMS will continue to analyze vaccination data for residents and staff from the CDC’s National Healthcare Safety Network (NHSN) data as an additional method of compliance monitoring and in keeping with current practice, as well as deploy the Quality Improvement Organizations (QIOs)—operated under the Medicare Quality Improvement Program—to educate and engage nursing homes with low rates of vaccinations.

CMS strongly encourages nursing home residents and staff members to get vaccinated as the Agency undergoes the necessary steps in the rule-making process over the course of the next several weeks. CMS expects nursing home operators to act in the best interest of residents and their staff by complying with these new rules, which the Agency expects to issue next month.  CMS also expects nursing home operators to use all available resources to support employees in getting vaccinated, including employee education and vaccination clinics, as they work to meet this staff vaccination requirement.

Rhode Island Long Term Care Facilities with new cases in the last 14 days (as of 8/14/2020):

These RI nursing homes are on the RI Dept. of Health list with increased cases –

Alpine – Coventry – 5-9 cases

Avalone – Warwick – less than 5

St. Antoine – North Smithfield – less than 5

Woonsocket Health – Woonsocket – less than 5

All America Assisted Living – Warwick – less than 5

Anchor Bay – Johnston – less than 5

Smithfield Woods – Smithfield – less than 5

Sunrise House – Providence – less than 5

Bridge at Cherry Hill – Johnston – 5-9

Tockwotton – Providence – less than 5

AARP Strongly Supports Biden’s Vaccine Mandate in Nursing Homes 

In response to the Biden Administration directing all nursing homes that receive Medicare or Medicaid funds to require vaccinations for all staff, Nancy A. LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer, stated:  

“The Administration’s announcement today requiring vaccinations for nursing home staff is a significant step in the fight against this pandemic. Around 30% of COVID deaths have been among residents and staff in nursing homes and other long-term care facilities, even though they represent less than 1% of the population. As the new variants are emerging, facilities cannot let preventable problems be repeated. Increasing vaccination rates in nursing homes is one of the most common sense and powerful actions we can take to protect the lives of vulnerable older adults.”

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.

Don’t Just Single Out Nursing Homes 

“We appreciate the Administration’s efforts to increase COVID-19 vaccinations in long term care. Unfortunately, this action does not go far enough. The government should not single out one provider group for mandatory vaccinations. Vaccination mandates for health care personnel should be applied to all health care settings. Without this, nursing homes face a disastrous workforce challenge,” warns Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) 

“Focusing only on nursing homes will cause vaccine hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents. It will make an already difficult workforce shortage even worse. The net effect of this action will be the opposite of its intent and will affect the ability to provide quality care to our residents. We look forward to working with the Administration in the coming days to develop solutions to overcome this challenge,” says Parkinson.

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.

COVID-19 and 2021: Looking into the Crystal Ball

Published in the Pawtucket Times on December 28, 2020

Novel coronavirus (COVID-19) cases continue to surge across the nation.  Yesterday, nearly 18,986,236 Americans have contracted COVID-19 with over 331,930 dying, says the John Hopkins Coronavirus Research Center. Projection models say that deaths may spike to over 500,000 by March 2021.

As 2021 approaches, the Centers for Disease Control and Prevention (CDC) has announced that 1.9 million people throughout the nation have gotten a dose of COVID-19 vaccine.  CDC also warned that a new variant COVID can be more rapidly transmissible than other circulating strains of SARS-COC-2.

Even with the dissemination of a safe and effective COVID-19 next year, many experts say that COVID-19 will around for a long time.  We are now seeing New Year predictions being made about COVID-19’s future impact on the delivery of care to seniors. The New York-based Aloe Care Health, one of the world’s most advanced voice-activated medical alert and communication service for elder care, recently brought seven experts together, to make predictions as to how COVID-19 pandemic will impact the provision of healthcare, insurtech, caregiving services and aging services in the upcoming year.  

Predictions from Health Care Experts

According to a statement released by Aloe Care Health on Dec. 22, these invited experts see a ‘Better Year Ahead.”  Here are some of their insightful predictions: 

Jay H. Sanders, M.D., CEO, The Global Telemedicine Group, member of the Aloe Care Advisory Board, observed: “The best examination room is where the patient lives, not where the doctor works. And, any variant of the following: telemedicine is to healthcare as Amazon is to shopping; as Netflix is to the movie theater, and as on-line banking is to your local bank.” 

“While 2020 turned the world upside down, it also revealed the massive gaps and deficits that exist in caregiving and senior care. I think 2021 will be the ‘Year of the Caregiver’ as companies, the senior care industry, and leading service organizations come to terms with how to best serve these underpaid and undervalued everyday heroes,” stated Amie Clark, Co-Founder and Senior Editor at the Clackamas, Oregon-based The Senior List.  

Donato Tramuto, Author, Chairman and Founder of Health eVillages, noted: “After a year highlighted by the devastating impact of COVID-19, vaccinations and other measures bring us hope to combat the virus in 2021. However, it is also important that we pay attention to the unintended consequences of COVID-19. As we safely social distance to decrease exposure risk, we must find ways to intervene and deal with the social isolation and loneliness caused by the lack of connection. I expect the next decade to bring innovations in business and healthcare to help us rebuild our community of connections and address the loneliness epidemic.” 

“Aging-in-place will continue to gain traction. Remote patient monitoring, personal emergency response technology, and other health matters will be addressed in-home. Health Insurance companies will redouble efforts to advance digital care management, using data to prevent acute health episodes. Covid19 will accelerate the digital adoption of remote patient care and communication. Masks will be required or desired in many public forums for much of 2021. Sadly, social distancing may be here to stay,” predicted Bob Hurley, Executive Advisor in Digital Health, eHealth; member of the Aloe Care Advisory Board. 

“COVID has demonstrated the power of telehealth to support health care workers, the older population and caregivers. It is amazing to see the adoption rate grow amongst all ages and the importance it addresses for the safety and independence of vulnerable populations. I expect innovative concepts to grow and expand in 2021 that will further empower providers and the population as a whole to live healthier and fulfilling lives,” anticipates Vicki Shepard, Health and Aging Expert, co-founder of Woman Business Leaders (WBL): Women Leading Healthcare 

“The last several months have given every one of us a dose of radical empathy for people who are isolated and alone. My profound hope is that this translates into better care for one another, especially older adults, in 2021 and beyond. And as our population ages overall (more than 10,000 of us reach 65 every day), I hope too that we collectively evolve beyond so many limiting, false, and often unconscious preconceptions about aging. This starts with products that are more thoughtfully, more beautifully designed, and extends right through to our everyday interactions.” Says Ray Spoljaric, CEO and Co-Founder, Aloe Care Health  

Finally, Jordan Mittler, Director and Founder of Mittler Senior Technology, adds: “In 2021, older adults will continue to rely on simple technology to interact with friends and family, as well as to function independently. Normalcy will take time to resume, and senior communities need to use home devices to function in society. Online shopping, online healthcare, online banking, and virtual communication will be major components of the lives of elders as we go into 2021.”  Jordan leads an inspiring group of teens teaching elders how to use technology to improve communication and daily activities. 

Predictions from a Rhode Island Physician

Over the months, Michael Fine, M.D., Chief Health Strategist, City of Central Falls, says that the COVID-19 pandemic made seniors to feel isolated and vulnerable. “As people get vaccinated it will let people feel more comfortable about moving around.  But January and February will be very hard month,” he warns. 

As we move into 2021, Fine predicts that “many people will think twice before moving to congregate settings of any sort, and we will live with new and burdensome precautions for a long time.”  He thinks that Rhode Island will lose some of its assisted living facilities and nursing homes due to the ongoing pandemic.  

Next year, Fine recommends that older Rhode Islanders stay close to home until they are vaccinated and use food delivery services where possible.  “The best way to cope is to use the telephone a lot and go out walking as much as possible, and to listen to lots of music and read a lot,” he says.   

“COVID-19 has changed how we live our lives.  Wearing a face mask and social distancing are the new normal. “I think we will go back to life as it was.  But it will take 3 to 5 years,” says Fine.   

Fine, who formerly served as the state’s Director of Health, has some thoughts about combating the COVID-19 surge in the Ocean State.  “My advice continues to be to shut bars and restaurants for indoor dining and to keep schools open, until we drop to below 2 new cases/100,000 population per day.  Everyone who works outside their homes should be tested twice a week, and every employer should make sure that’s happening, and everyone positive should be isolated for 10 days, and all contacts go into quarantine. We need employers to take the lead on this, because government has not been able to get it done,” states Fine.

Spotlight on Government Action

“It is time we all look hard at our political leadership, which has chosen to keep factories, bars and restaurants open, at the cost of hundreds of lives and a robust economy, while the virus is spreading in our communities, hitting people of color hardest.  We need to look at ourselves and our faith communities as well, allowing this to happen instead to speaking up for the sanctity of human life,” says Fine. “Democracy depends on the consent of the governed.  We all went along.  This response represents the most fundamental kind of institutional racism, the kind that puts profit in front of the lives of people of color and the communities in which people of color live,” he adds.

“All level of government failed.  SARS-CoV-2 is a cold virus.  We remain completely unprepared for a truly dangerous virus, which is evolving somewhere around the world, and will hit elders and people of color hardest again,” warns Fine. 

AARP Town Hall Gives Its Best to Educate Seniors on COVID-19

Published in the Woonsocket Call on April 5, 2020

With more than 278 Americans now infected with the Coronavirus virus (COVID-19) and at least 7,159 people dying from the deadly virus, according to an April 3 blog article the New York Times, “about 311 million people in at least 41 states, three counties, eight cities, the District of Columbia and Puerto Rico are being urged to stay home.” The Washington, DC-based AARP continues to intensify its efforts to educate seniors about COVID-19 by hosting weekly Coronavirus Information Tele-Town Hall events.

At AARP’s second Coronavirus Information Tele-Town Hall event, held Thursday, March 19, during the 90 minute live event, federal health experts gathered to answer questions about the latest changes to address the health impacts of COVID-19, family caregiving needs, and to give tips on how seniors can stay safe from scams and frauds. AARP’s Vice President Bill Walsh served a host and the panel of experts featured Dr. Jay Butler, M.D., the deputy director for infectious diseases at the Centers for Disease Control and Prevention, (CDC), Lance Robertson, the assistant secretary for aging and administrator of the Administration for Community Living (ACL) and Daniel Kaufman, the deputy director for the Federal Trade Commission’s Bureau of Consumer Protection. AARP’s Jean Setzfand. AARP’s senior vice president served as moderator.

CDC’s Butler called for the public to stay informed and take the coronavirus virus seriously. “As we’ve learned more about COVID-19, it’s very clear that most people who become infected do recover and do very well. But unfortunately, some get very sick. And some even die. And the risk of more severe illness is greatest for those who are older and for persons with underlying health conditions, especially chronic heart, lung or kidney disease, and those with diabetes,” he says.

Juggling Costs and Benefits While Promoting Social Distancing

According to Butler, grocery stores are juggling costs and benefits with promoting social distancing by designating special hours for seniors to shop if they don’t have someone who can make “that run to the grocery store or have delivery services available.”

“We’re at the end of flu season so if you develop symptoms (cough, muscle aches, headache, and temperature) it doesn’t mean that you have COVID-19, says Butler. For those concern, it is important to talk with your health care provider who will determine whether or not you should be evaluated and whether or not a test may be necessary, he adds, noting that COVID-19 testing is now covered by Medicare Part B when it’s ordered by a health care provider.

“Of course, if you suddenly become very ill—and that would be things like shortness of breath, chest pain, difficulty in getting your breath at all or noticing that your face or your lips are turning blue—that’s when you call 911, and get in as quickly as possible,” says Butler.

Butler notes that the primary transmission of the COVID-19 virus (as well as the six other coronaviruses that were previously known to cause disease in humans), is respiratory droplets.

By coughing or sneezing you produce droplets that contain the virus that can spread as far as five or six feet away from you, he says stressing that this is why social-distancing can protect you from catching the virus.

Many express concerns that COVID-19 can be picked up by handling letters and packages. But, says that the likelihood of transmission of is extremely low. So, consider sending a package a loved one in an assisted living facility or nursing home because it can be meaningful, says Butler.

For those over age 75 to age 80, Butler recommends that these individuals practice social distancing by connecting with their children or grandchildren by phone video chat to being exposed to COVID-19.

Butler gave simple tips for residents of senior living complexes to protect themselves from COVID-19. When you come back into your apartment after taking out trash to the chute or dumpster, “wash your hands,” he says. “And that means about 20 seconds with soap and water.

It seems like a long time but it’s the same amount of time it usually takes getting through the alphabet or to sing Happy Birthday twice,” adds Butler. Or just use a hand sanitizer with at least 60 percent alcohol as an alternative to hand washing.

ACL Administrator Robertson provided tips to unpaid caregivers who cannot visit their loved ones in nursing homes due to the necessary visiting restrictions. He says, get the facility’s up-to-date contact information along with details as to ways as how to make virtual visits, video chats and regular phone calls. He says, don’t forget to send cards and notes, not only to your loved one, but to other residents even to staff to say thank you.

Communicating with Your Loved Ones

Enhance your verbal communication by asking the facility staff to schedule the time for your call. “If your mom is most alert in the morning, pick a morning time, think about what music they might like and play that in the background or sing along or sing directly to your loved one,” recommends Robertson.

Robertson notes, “If you find the conversation struggling a bit, maybe play a game of trivia, reminisce, work on a crossword puzzle together, sing songs, read poetry or other materials.

Watch a TV show at the same time and just discuss. Again, throw in some creativity and you can help prevent both boredom and isolation.”

For those more technically savvy, face-to-face interaction through FaceTime, Messenger, Facebook, Zoom, can enhance your contact, says, Robertson.

Adds Robertson, make sure you ask the facility staff to keep the scheduled time of the care conference, holding it over the phone. “We know they’re busy, but it’s imperative that you remain linked as a caregiver,” he says.

For those caregivers seeking resources to take care of their loved one at home, call ACL’s Eldercare Locator, recommends Robertson. It’s toll-free 1-800-677-1116.

During this COVID-19 emergency FTC’s Daniel Kaufman warned that you will see “unscrupulous marketers” trying to take advantage of senior’s fears by selling them bogus treatments. In early March, he told the listeners that the FTC and the U.S. Food and Drug Administration (FDA) sent out warning letters to seven companies that were claiming products (such as cheese, essential oils and colloidal silver) could treat or prevent the coronavirus. He quipped, these companies are not making these claims anymore and urged seniors to report any scams they come across by going to ftc.gov/complaint.

Kaufman says that seniors can also go to ftc.gov/coronavirus or just go to ftc.gov to see a very prominent link for coronavirus scams. If you want to receive consumer alerts directly from the FTC, you can go to ftc.gov/subscribe.

Skyrocketing of COVID-19 Related Scams

According to Kaufman, FTC is seeing an increase in scams, from phishing emails, charity and stock scams, to robocalls selling cleaning supplies and masks.

“We are seeing a lot of bogus emails that are going out to consumers, that use headers about coronavirus to get people to open them. You know, these are fake emails that are purporting to come from legitimate and important organizations like the World Health Organization or the CDC,” says Kaufman. “Don’t click on links when you get those emails. Don’t open those emails. They will download viruses or be harmful to software onto your computer, or they will try to get your private information or credit card information,” he adds.

Watch out for charity scams, too, warns Kaufman. “You know, this is a difficult time and we all want to help. But we want to make sure we’re helping charities and not scammers who are pretending to be charities, he says, suggesting that you do your homework to protect your pocketbooks.

With COVID-19 spreading across the nation you are now seeing more robocalls touting products and services to protect you from being exposed to virus. “Just hang up. Keep in mind that anyone who’s robocalling you, if they’re trying to sell you a product, they’re already doing something that’s unlawful,” he says.

Kaufman also recommends that seniors use a credit card when purchasing products, whether it’s cleaning supplies or masks, on websites. “It’s pretty easy to set up a website that’s purporting to provide, to sell these kinds of products. And they’re taking consumers’ payment information but not delivering, he notes.

Finally, Kaufman urges seniors to watch out for watch out for fraudsters who are touting that a certain company’s stock that is certainly going to explode because they have products that can treat coronavirus. Don’t fall for this stock scam and buy this stock.

For the latest coronavirus news and advice, go to http://www.AARP.org/coronavirus.

To see transcript, go to http://www.aarp.org/health/conditions-treatments/info-2020/tele-town-hall-coronavirus-03-19.html.