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

Opposition Builds Against Elimination of Social Security’s Payroll Tax

Published in the Pawtucket Times on September 28, 2020

With the looming 2020 presidential elections, the National Committee to Preserve Social Security and Medicare (NCPSSM) announces its first ever Presidential endorsement, throwing its support to the Joe Biden/Kamala Harris campaign. The Washington, DC-based aging advocacy group, founded by James Roosevelt, Jr., the son of President Franklin D. Roosevelt, who is credited with founding Social Security, fears for the retirement program’s future survival under a second Trump term. NCPSSM’s endorsement breaks the National Committee’s 38-year tradition of steering clear of Presidential campaigns in order to focus its resources on House and Senate races.

NCPSSM support of Biden follows the endorsements of other aging advocacy groups including AARP, Social Security Works, Alliance for Retired Americans, Medicare for All, American Federation of Government Employees and National Treasury Employees Union.

“During the past four years, we’ve seen this president pay lip service to seniors’ needs while actively undermining their best interests, the latest example being his reckless pledge to terminate the payroll taxes that fund Social Security and Medicare,” says NCPSSM’s president and CEO Max Richtman. “As the pandemic has worsened, we have seen an abject failure to protect nursing home residents and workers, who represent 40 percent of all COVID deaths. Never in our organization’s history have we seen such a consistent level of threats to the health and retirement security of America’s seniors,” he added, noting that the most effective way to protect the solvency of Social Security is to elect Joe Biden as president,” he said.

Adds, James Roosevelt, Jr., Vice-Chairman of the National Committee’s advisory board, “By enacting Social Security, my grandfather, President Franklin Roosevelt, gave workers the promise of dignity and financial security in retirement. Thirty years later, President Lyndon Johnson signed Medicare into law, providing older Americans with affordable, accessible health insurance. There’s a reason Social Security and Medicare have been around for 85 and 55 years, respectively. Americans value and depend on them. My father and grandfather would be outraged that President Trump and his allies want to dismantle both programs. I am 100 percent behind the National Committee’s decision to endorse Joe Biden, the candidate who can be trusted to protect seniors’ earned benefits from any attempts to undermine or privatize them.”

Trump’s Changing Policy Positions on Social Security

On Oct. 4, 2016, at vice presidential debate at Longwood University, Democratic vice-presidential nominee Tim Kaine noted that in 2000, Donald Trump wrote a chapter in a book, The America We Deserve, calling Social Security a” Ponzi scheme” [an investment fraud] and stating that “privatization [of the program] would be good for all of us. ”

One month before Trump formally announced his candidacy on June 16, 2015, with a campaign rally and speech at Trump Tower in New York City, he tweeted, “I am going to save Social Security without any cuts. I know where to get the money from. Nobody else does.”

As a presidential candidate, Trump continued calling for protecting Social Security, long regarded as one of the most successful and popular social programs ever enacted by Congress. During a June political rally in 2016, Trump claimed, “We’re going to save your Social Security without killing it like so many people want to do” and throughout the 2016 presidential campaign repeatedly promised “not to touch” seniors’ earned benefits and to “protect your Social Security and your Medicare.”

Once in the Oval Office, Trump’s views changed. Congress was forced to block his proposed budget cuts and rule changes that would hurt Social Security beneficiaries, says Richtman.

“Trump has betrayed older Americans through his bungled response to the COVID pandemic and by blatantly breaking his promises to protect senior’s cherished social insurance programs. He has proposed more than $1 trillion in cuts to Social Security, Medicare and Medicaid. He has vowed to eliminate the payroll taxes that fund seniors’ retirement and health benefits if re-elected to a second term. He has urged the Supreme Court to strike down the Affordable Care Act, which improved Medicare benefits and solvency. In short, the President has listened to advisors who want to dismantle the country’s most effective social safety net programs” says NCPSSM’s top official.

A Stark Warning

On August 8, Trump has signed an Executive Order, Deferring Payroll Tax Obligations in Light of the Ongoing COVID-19 Disaster, to authorize a payroll tax holiday/deferral to give American taxpayers extra cash as they deal with the coronavirus pandemic. The president’s action allows employers to stop deducting the 6.2 percent employee payroll contribution toward Social Security for the rest of the year.

An Aug. 28 IRS memo noted that employers who participate in the payroll tax holiday will then have to pay back the taxes starting in 2021. Simply put, more money will take out paychecks from Jan. 1 to April 30 in 2021 to repay the taxes owed.

Richtman warns, don’t count on payroll tax forgiveness. “Unless Congress passes legislation to address this, the workers will ow every cent of that payroll tax deferral in 2021, and employers would have to deduct more from their paychecks starting January to repay it,” her says.

NCPSSM, Democratic lawmakers, and Social Security advocacy groups don’t see Trump’s elimination of the Social Security payroll taxes as an effective economic stimulus especially to unemployed workers. This action could effectively defund the Social Security and Medicare programs could ultimately bankrupt these programs.

In the letter released on Sept. 23 , Nancy A. LeaMond, AARP’s Executive Vice President and Chief Advocacy and Engagement Officer said “As AARP raised in letters to Congress back in March and President Trump and Treasury Secretary Mnuchin in August, we believe suspending, reducing, or eliminating contributions to Social Security will interfere with the program’s long-term funding stream… This deferral, along with the President’s recent statements on the permanent elimination of the Social Security payroll tax contribution, are engendering uncertainty among older Americans and the general public about Social Security and its ability to pay promised benefits. As such, AARP supports the resolution of Congressional disapproval.”

Trump counters NCPSSM, AARP and others condemning his Executive Order. He claims that eliminating the Social Security tax would not impact the solvency of Social Security, because the money would be shifted from the government’s general fund. Both continuing his payroll tax cut and shifting funds would require Congressional action. That, also, would require an act of Congress.

With this first time political endorsement, NCPSSM hopes to see a Democratic administration take over the White House to strengthen and expand Social Security, not weaken it by eliminating the program’s payroll taxes. “After nearly four decades of fighting to protect American seniors, the National Committee has determined that many older Americans cannot afford – let alone survive – another four years of President Trump. By endorsing Joe Biden and Kamala Harris today, we will work tirelessly to help voters of all ages understand that Trump’s promises are empty. He offers seniors a one-way ticket to nowhere. Americans deserve a President who will protect and strengthen the federal government’s commitment to older Americans.”

This article was updated on Sept. 24.