Tag Archives for Medicare

Tackling surge of COVID-19 in Nursing Homes

Published ion RINewToday on December 15, 2020

Over the months, while public health officials watch the uptick in new COVID-19 cases, Congress releases two reports, one taking a snapshot of nursing home performance and resident deaths throughout the first eight months of the pandemic, and the other one sounding the alarm about the impact of COVID-19 on the nation’s nursing homes and warning it is now getting worse.  

About three months ago, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) announced the release of a 67-page report on care provided in nursing homes and other long-term care facilities throughout the nation during the ongoing COVID-19 pandemic. The comprehensive report, titled “COVID-19 and Nursing Homes: What Went Wrong and Next Steps,” reviewed U.S. nursing home performance during the early fall and summer months of the pandemic. According to the report, more than two out of five deaths due to COVID-19 in the United States are linked to nursing homes and other long-term care facilities.

Stopping the Spread of COVID-19 in Nursing Homes

“Partisan finger pointing, rather than meaningful analysis, cannot serve as a useful guide for policymakers in crafting the necessary bipartisan reforms in response to the unprecedented challenges facing this entire sector and its employees working on the frontlines during this pandemic,” says the Senate Finance committee report, released on Sept. 23. It stressed that suggestions that coronavirus-related deaths in nursing facilities “are attributable solely, or even primarily, to acts or omissions by the current administration falls well short of addressing the multi-faceted problems in this sector.”

The report added, “Such a one-dimensional approach necessarily overlooks several factors that fueled the outbreak of COVID-19 in nursing homes across the United States, and around the world. Minimizing, or devoting scant attention to such factors, makes it enormously difficult for members of Congress to come together in support of long-overdue reforms and bipartisan solutions to the complex problems facing nursing homes today.” 


The report, produced by the majority staff of the Senate Finance Committee, examined what steps might have prevented these fatalities by minimizing the spread of COVID-19 in the facilities and discussed what actions could be taken now to slow the surge of deaths in nursing homes during this and future pandemics.  

While new coronavirus cases have surged to nursing homes throughout the nation and despite federal and state efforts to stall the spreading of the virus, the Senate Finance Committee report noted that facilities have already received significant relief assistance from Congress and the Trump administration totaling approximately $21 billion in addition to technical assistance, guidance and training.

The report’s findings noted that for years preceding the COVID-19 outbreak in March, private nursing homes have had widespread deficiencies in infection control and prevention.  The majority staff also found that state governments and health officials in some of the hard-hit states fell short of their responsibility to ensure quality care, and in multiple states, staffing and supply shortages persisted for years prior to the pandemic. 

Nursing homes around the world have struggled with many of the same issues as the United States during the pandemic, including Europe, the United Kingdom and Canada, noted the report.

State governments in some cases also failed to enforce federal guidelines for these care facilities as required through their participation in Medicare and Medicaid, particularly guidance provided to minimize coronavirus transmission in their facilities, noted the report. In addition, the majority staff found that nursing home staff who work in multiple facilities unknowingly played a key role in spread of COVID-19 in nursing homes. 


Finally, the Senate Finance Committee report also noted that several governors pressured nursing facilities to accept COVID-19 patients when personal protective equipment (PPE) was still in short supply and some did so even after the federal government made temporary hospitals available in their jurisdictions. 
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The Senate Finance Committee report provided, to members of the Senate Finance Committee with detailed background information on the many challenges that nursing homes continue to face during this year’s public health crisis. It provides Congressional lawmakers with specific recommendations, based on best practices that some facilities and public officials adopted during the ongoing pandemic to protect their residents and staff.  It also includes additional suggestions to better protect the nation’s older Americans from elder abuse, neglect and exploitation.

 
Updating the Grim Toll of COVID-19 Deaths in Nursing Homes 

Last week, U.S. Senators Bob Casey (D-PA), Ranking Member of the Special Committee on Aging, and Ron Wyden (D-OR), Ranking Member of the Finance Committee, released their report that warned that the already dire situation in nursing homes is worsening.

“It’s with great sadness that we are once again giving a grim update on the toll that COVID-19 is continuing to take on nursing homes. It’s abundantly clear that inaction has contributed to the loss of more than 104,000 mothers, fathers, grandparents, friends and neighbors who lived and worked in nursing homes and long-term care facilities across the country,” said Senators Casey and Wyden, in a statement announcing the report released on Dec. 10. “Experts are predicting that we are heading into the most severe months of the COVID-19 pandemic, marred by climbing caseloads and increasing stress on our Nation’s health care system,” they say, calling on the Senate colleagues to hammer out and pass a comprehensive COVID-19 relief bill. 

According to the eight-page report, entitled, “The Cost of Inaction: 19 Deaths an Hour and Rising,” last month, more than 15 nursing home residents died from COVID-19 per hour, with 19 residents dying each hour during the week of November 22, 2020, the most recent week reported.

The Senate Aging Committee report noted that the number of weekly COVID-19 deaths among nursing home residents has increased 133 percent since Labor Day, and 96 percent among nursing home workers during the same period. Workforce shortages have also increased since Labor Day: In November, one in six nursing homes nationwide reported that they do not have a sufficient workforce, says the report.

The Democratic Senators warned that COVID-19 cases will surge in nursing homes if Congress does not come together to hammer out bipartisan legislation to stop the spread of the pandemic.

These new report findings serve as a warning as to what will come if Congress does not come together to alleviate the COVID-19 crisis in nursing homes, says Casey and Wyden. It calls for a national strategy to save lives in nursing homes, including providing facilities with a sufficient supply of PPE, ample access to testing, resources for vaccine distribution, funding for strike teams and adequate workforce supports, and accountability measures to uphold resident rights and permit safe visits with family.

Finally, in the Ocean State…

Just days ago,the latest update of the AARP Nursing Home COVID-19 Dashboard, released by AARP’s Public Policy Institute, unveiled a new report in a series on improving the care of care provided in the nation’s nursing homes. “Rhode Island’s nursing homes continue to face alarming trends,” says the AARP report.

Using data released 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 dashboard will continue to be updated every four weeks.

In the four weeks analyzed, from October 19 to November 15, AARP’s dashboard reports that Rhode Island nursing homes had a dramatic increase in resident and staff cases, and a higher percentage of facilities reporting they are without a 1-week supply of PPE.

“With coronavirus surging across the country, nursing home residents and staff remain in grave danger as the virus reenters nursing homes and other facilities at an alarming pace,” said AARP State Director Kathleen Connell.  “Facilities continue to have shortages of the staff and PPE needed to keep residents and workers safe and stop the spread. Our state leaders must act now to save lives,” she said.

Connell added, “AARP will continue fighting to protect nursing home residents now and offering solutions to improve our long-term care system for the decades to come.”

For copies of Senate reports go to: https://www.aging.senate.gov/imo/media/doc/The%20Cost%20of%20Inaction.%2019%20Deaths%20and%20Hour%20and%20Rising.pdf; 

https://www.finance.senate.gov/imo/media/doc/SFCNursingHomesCOVIDMajorityStaffSFCReport23Sep2020FINAL.pdf.

The complete dashboard is available at aarp.org/nursinghomedashboard.

Democrats Will Have to Compromise if They Lose Georgia Senate Run-Off

Published in the Pawtucket Times on December 7, 2020

With Democratic presidential candidate Joe Biden taking the White House, the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) called on Congressional lawmakers to address the needs of older Americans during lame-duck session ending Jan. 3 and throughout President Biden’s first 100 days in office.  Can Congressional lawmakers put aside political differences to pass a last-ditch Stimulus package compromise, a defense bill, and consider aging legislation piling up in just 27 days when the lame-duck session ends?  Will there be political grid lock after President Biden takes office on Jan. 20 if the GOP maintains control of the Senate block Congress from taking up legislation impacting older Americans?

Legislation Piling Up in Lame-Duck Session

“Though this is normally a time when expectations for Congressional action are low, the National Committee expects our elected representatives to act on behalf of seniors and other struggling Americans hit hard by the pandemic,” says NCPSSM president and CEO Max Richtman, in correspondence sent to Congress on Dec. 3.

Across the nation seniors are the hardest hit age group by the ongoing coronavirus pandemic.  “Eight out of 10 deaths from COVID in the U.S. have been in adults 65 years old and older. Whether as part of an omnibus funding bill, continuing resolution or COVID relief package, The National Committee is urging lawmakers to pass urgently needed measures for seniors,” says Richtman.

Richtman calls on Congress to address the Social Security “Notch” issue. He warns that if Congress doesn’t take action, workers born in 1960 and 1961, will see lower Social Security retirement benefits in the future. According to the Chief Actuary of Social Security, this will sharply reduce benefits for those born in 1960 compared to the benefits received by people born just one year earlier, creating an effect known as a “notch,” notes NCPSSM’s correspondence.

Congress can correct this notch in Social Security benefits by passing Rep. John Larson’s (D-CT) H.R. 7499, the “Social Security COVID Correction and Equity Act,” says Richtman.  The legislative proposal would increase benefits for those born in 1960 and 1961 without impact the benefits for any other beneficiary. 

In October, the Social Security Administration announced that approximately 70 million Americans would see a meager 1.3 percent increase Social Security benefits and Supplemental Security Income. “More than half of seniors receive over one-half of their income from Social Security, and it provides at least 90 percent of income for more than one-in-five seniors.  These seniors are dependent on a reasonable COLAs to maintain even a modest standard of living in retirement,” said Richtman.

With retirees experiencing financial difficulties during the pandemic, a $20 increase in their monthly check might not help them to pay for spiraling health care and drug costs, along with the expenses of purchasing personal protective equipment and cleaning supplies to keep them safe. 

Richtman’s correspondence also pushes for passage of Rep. Peter DeFazio’s H.R. 8598, “Emergency Social Security COLA for 2021 Act,” to provide Social Security beneficiaries with a 3 percent increase (or a $250 per month flat increase) which would reduce the impact of the small 2021 COLA increase. 

Protecting the Fiscal Viability of Social Security

Last August, NCPSSM and aging advocacy groups opposed President Trump’s signed executive order that would allow employers to defer workers’ payroll tax contributions for the rest of the year.  Between Jan. 1, 2021 and April 30, 2021, these employees will be required to pay back their deferred payroll taxes, doubling their FICA taxes for the first four months of 2021.  The National Committee has supported efforts to ease the burden for those affected by this hardship. 

NCPSSM correspondence also called on Congress to extend a protection to lower-income Medicare and Medicaid beneficiaries, including ‘Money Follows the Person’ (which provides funding for states to help skilled nursing care patients to remain in their homes) and impoverishment protections for the spouses of Medicaid recipients receiving long-term care.

Finally, Richtman requested extending the funding for Medicare Low-Income and Enrollment Assistance, which provides funding for State Health Insurance Assistance Programs and Area Agencies on Aging to assist low-income seniors access programs such as the Medicare Prescription Drug Program Part D Low-Income Subsidy.

NCPSSM’s “wish list”, detailed in Richtman’s correspondence, could easily be rolled into a continuing resolution that Congress must pass by Dec. 11 to get the federal government operational. But, any of the legislative proposals pushed by The National Committee would be bottled up in the Senate, by GOP Senate Majority Leader Mitch McConnell, referred to as the “grim reaper,” he Republicans maintain control of the Senate during the 117th Congress.

GOP ‘Grim Reaper’ Keeps Democratic Bills from Consideration

Last February, on Fox News Friday, anchor Bret Baier asked McConnell to confirm Democratic charges that House passed and Senate proposed legislation would never see the light of day on the Senate Floor.  At the time of this interview, the GOP Senator, controlling his chamber’s legislative agenda, confirmed that 395 bills sitting in his chamber would not be passed.

“It is true,” admitted McConnell during the Fox News interview.  “They’ve been on full left-wing parade over there, trotting out all of their left-wing solutions that are going to be issues in the fall campaign. They’re right. We’re not going to pass those.,” he said, recognizing the politics of a divided government. 

McConnell’s ‘Legislative Graveyard’ created by his blocking debate, markup and refusing to allow a vote on Democratic proposed legislation is well documented in the press and by a report released last September by Common Cause, a watch dog advocacy group with chapters in 35 states. “In fact, the Senate’s inaction has the 116th Congress on track to be the least productive in history, with just one percent of the bills becoming law [between] January 3, 2019 to September 16, 2020],” said Aaron Scherb, Common Cause’s director of legislation and author of the 2020 Democracy Scor

During an interview published on Sept. 16, 2020 in Newsweek, Scherb said, “There have been hundreds [of bills] that have been passed by the House at this point.  There have only been 158 enacted laws by this 116th Congress to this point.  Yet there are hundreds of bills that have passed the House but continue to sit in Senate Majority Leader McConnell’s desk, or his ‘legislative graveyard’ as it’s been called.”

With McConnell winning his reelection, the senator from Kentucky can only maintain control of the Senate’s legislative agenda if he can keep two GOP Senate seats up for grabs in next month’s Senate runoff in Georgia.  A Democratic win will give the party a majority 50 Senate seats, with Vice President Kamala Harris breaking a tie.

In order to pick up the two GOP Senate seats, held by incumbent Senators David Perdue and Kelly Loeffler, Democrats must successfully mobilize voters and adequately fund the campaigns of Democrat Jon Ossoff and Raphael Warnoc. At press time, millions of campaign dollars are pouring into Georgia’s Senate runoff elections, with the two GOP Senators bringing in more campaign donations because of Republican super-PACs giving them the spending edge. The Democrats are receiving their political contributions through small donors.

Even with the Democrats controlling the White House and House of Representatives, if McConnell maintains control of the Senate, legislative gridlock in the upper chamber will most certainly continue.  This will make it more difficult for the NCPSSM and other Washington, DC-based aging advocacy groups to successfully push for passage of legislation to ensure the financial security and health of seniors

Study: COVID-19 Changes Way Americans Think About Retirement

Published in RINewsToday on November 23

The raging coronavirus pandemic is changing the fundamental way working adults think, plan and save for their retirement, underscoring the important role Social Security and Medicare play for retirees, according to the 2020 Wells Fargo Retirement study conducted by The Harris Poll in August. The annual research report examines the attitudes and savings of working adults, taking a look this year on the impact of the COVID-19 pandemic on retirees.

For those workers whose jobs were negatively impacted by COVID-19 over the last eight months, the Wells Fargo study found that planning for retirement has become even more challenging, with many survey respondents expressing “pessimism” about their life in retirement – or worried if they can even retire. 

This year’s Harris Poll conducted 4,590 online interviews, from Aug.3-Aug. 24, including 2,660 working Americans age 18-76 whose employment was not impacted by COVID-19, 725 Americans age 18-76 whose employment was impacted by coronavirus pandemic, 200 high net worth American workers age 18-76, and 1,005 retired Americans, surveying attitudes and behaviors around planning their finances, saving, and investing for retirement.

According to the Wells Fargo study’s findings, 58 percent of workers impacted by the pandemic say they now don’t know if they have enough savings for retirement because of COVID-19, compared to 37 percent of all workers. Moreover, among workers impacted by coronavirus, 70 percent say they are worried about running out of money during their retirement while 61 percent say they are much more afraid of life in retirement, and 61 percent note that pandemic took the joy out of looking forward to retirement.

The study, released Oct. 21, found that COVID-19 has driven some workers even further behind in saving for retirement: Working men reported median retirement savings of $120,000, which compares to $60,000 for working women, say the researchers.  Yet for those impacted by COVID-19, men report median retirement savings of $60,000, which compares to $21,000 for women.

“With individual investors now largely responsible for saving and funding their own retirement, disruptive events and economic downturns can have an outsized impact on their outlook,” said Nate Miles, head of Retirement for Wells Fargo Asset Management in a statement releasing the findings of this study. “Our study shows that even for the most disciplined savers, working Americans are not saving enough for retirement. The good news is that for many of today’s workers, there is still time to save and prepare,” he says.

Taking a Close Look on Retirement Savings

The Wells Fargo study also found that women and younger generations are falling behind, too. Women are less sure if they will be able to save enough for retirement, and appear to be in a more precarious financial situation than men. The study findings indicate that almost half of working women (51 percent) say they are saving enough for retirement, or that they are confident they will have enough savings to live comfortably in retirement (51 percent). Those impacted by COVID-19 have saved less than half for retirement than men and are much more pessimistic about their financial lives. In addition, women impacted by COVID-19 are less likely to have access to an employer-sponsored retirement savings plan (59 percent), and are less likely to participate (77 percent).

According to the researchers, Generation Z workers (born between 1997 to 2012) started saving at an earlier age and are participating in employer-based savings programs at a greater rate than other generations, they are nonetheless worried about their future. Fifty-two percent of Generation Z workers say they don’t know if they’ll be able to save enough to retire because of COVID-19, 50 percent say they are much more afraid of life in retirement due to COVID-19, and 52 percent say the pandemic took the joy out of looking forward to retirement.

Remaining Optimistic

“The study found incredible optimism and resiliency among American workers and retirees, which is remarkable in the current [pandemic] environment,” said Kim Ta, head of Client Service and Advice for Wells Fargo Advisors. “As an industry, we must help more investors make a plan for their future so that optimism becomes a reality in retirement,” she said.

The Wells Fargo study findings showed that despite a challenging economy, many American workers and retirees remain optimistic about their current life, their future. Seventy nine percent of the workers say they are very or somewhat satisfied with their current life, in control of their financial life (79 percent), are able to pay their monthly bills (95 percent).  Eight six percent say they are still able to manage their finances.

The study’s findings indicate that 69 percent of workers and 73 percent of retirees feel in control and/or happy about their financial situation. Ninety two percent of the workers and 91 precent of retirees say they can positively affect their financial situation, and 90 percent of workers and 88 percent of retirees say they can positively affect how their debt situation progresses.

The researchers noted that 83 percent of workers say they could pay for a financial emergency of $1,000 without having to borrow money from friends or family. However, the respondents acknowledged they could improve their financial planning. Slightly more than half — 54 percent of workers and 50 percent of retirees — say they a detailed financial plan, and just 27 percent of workers and 29 percent of retirees have a financial advisor.

The study’s findings indicated that most respondents acknowledged that they could improve their financial planning. Slightly more than half — 54 percent of workers and 50 percent of retirees note they have a detailed financial plan, and just 27 percent of workers and 29 percent of retirees have a financial advisor.

Social Security and Medicare Key to Retiree’s Financial Security

The Wells Fargo study noted that despite an increasing shift to a self-funded retirement, in the midst of the pandemic, nearly all workers and retirees believe that Social Security and Medicare play or will play a significant role in their retirement.  According to the study, 71 percent of workers, 81 percent of those negatively impacted by COVID-19, and 85 percent of retirees say that COVID-19 reinforced how important Social Security and Medicare will be for their retirement. Sixty seven percent of workers say they have no idea what out-of-pocket healthcare costs will be in retirement, say the researchers.

The researchers say that workers expect that Social Security will make up approximately one-third of their monthly budget (30 percent median) in retirement. And even those high-net workers believe that Social Security and Medicare factor significantly into their retirement plans, expecting that the retirement program will cover 20 percent (median) of their monthly expenses.

The majority of the study’s respondents expressed concerns that the programs will not be available when they need them and worry that the government won’t protect them.  Specifically, 76 percent of workers are concerned Social Security will be raided to pay down government debt and 72 percent of workers are afraid that Social Security won’t be available when they retire.

The Wells Fargo study also found that 90 percent of workers would feel betrayed if the money they paid into Social Security is lost and not available when they retire and that 45 percent of workers are optimistic that Congress will make changes to secure the future of Social Security.