Tag Archives for Senator Bob Casey

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.

Bill Protects Nursing Home Residents, Providers

Published in the Pawtucket Times on June 1, 2020

This month, U.S. Senator Bob Casey (D-PA) and Senator Sheldon Whitehouse (D-RI) throw a bill in the legislative hopper to slow the spread of novel coronavirus (COVID-19) in nursing homes. It’s a common-sense legislative proposal and needed.

A recently released Kaiser Family Foundation study reported, “COVID-19 has had a disproportionate effect on people who reside or work in long-term care facilities, including the 1.3 million individuals in nursing homes; 800,000 in assisted living facilities; 75,000 in intermediate care facilities; and 3 million people who work in skilled nursing or residential care facilities.”

Combatting COVID-19 in Congregate Settings

With COVID-19 quickly spreading throughout the nation’s nursing homes and intermediate care facilities, Casey and Whitehouse’s legislative proposal, S. 3768, The Nursing Home COVID-19 Protection and Prevention Act, seeks to provide needed resources to facilities to protect frail residents and staff. Residents in these facilities are among the most vulnerable because of their age and underlying medical conditions. According to an analysis conducted by Gregg Girvan for the Foundation for Research on Equal Opportunity, as of May 22, in the 39 states that currently report such figures, 43 percent of all COVID-19 deaths have taken place in nursing homes and assisted living facilities

As more than 20,000 nursing homes residents and workers have died due to COVID-19, according to the latest reports, on May 19, 2020, Casey and Whitehouse introduced S.3768 to help states, nursing homes and intermediate care facilities put the brakes on the spreading of the deadly COVID-19. The legislative proposal, with 14 Democratic cosponsors (including Rhode Island Senator Jack Reed}, would help states implement strategies to reduce the spread of COVID-19 in congregate settings, including through the purchase of personal protective equipment (PPE) and testing and to support nursing home workers with premium pay, overtime and other essential benefits.

S. 3768 was referred to Senate Health, Education, Labor, and Pensions. As of March 30, 2020, a Congressional Budget Office cost estimate or this measure has not been received.

Days after the introduction of 25-page Senate legislative proposal, a House version (H.R. 6972) was introduced by Rep. Ana G. Eshoo (D-CA), cosponsored by Reps. Janice D. Schakowsky (D-IL), Donna E. Shalala (D-FL), Madeleine Dean (D-PA), Seth Moulton (D-MA) and David N. Cicilline (D-RI). The House bill was referred to House Energy and Commerce

“This virus spares no state, no county, no facility. The unprecedented crisis unfolding in our Nation’s nursing homes demands an immediate, extraordinary response. Reports indicate nursing home residents and workers account for roughly 1 in 4 deaths from COVID-19 in the United States,” said Casey, who serves as Ranking Member of the U.S Senate Special Committee on Aging, in a statement announcing the bill’s introduction. “The Nursing Home COVID-19 Protection and Prevention Act would provide $20 billion in emergency funding [for staffing, testing, Personal Protective Equipment, etc.] to devise a sorely needed national, coordinated response to stem the spread of this terrible virus in nursing homes and intermediate care facilities,” notes Casey.

According to Casey, the Senate bill would also require the U.S. Department of Health and Human Services (HHS) to develop guidance on cohorting best practices, including on how to safeguard resident rights. It would also instruct HHS to collect and publish data on COVID-19 cases and deaths in nursing homes and intermediate care facilities, and finally fund surge teams of nurses, aides, and other critical staff to fill in at facilities where multiple residents and staff members have been infected.

“COVID-19 poses an immediate threat to the more than 1.3 million Americans, including more than 7,000 Rhode Islanders, who live in nursing homes,” says Whitehouse, noting that frontline staff across the nation are “doing heroic work under very challenging circumstances.”

“We need to get vastly more personal protective equipment and tests to nursing homes, which care for the patients who are most vulnerable to the coronavirus. Our legislation would also help states fund surge teams, sending additional staff reinforcements to facilities where they are needed to care for patients and prevent infection,” adds Whitehouse.

Before S. 3768 was officially introduced, in early March, Washington, DC-based AARP announced its support for the Senate proposal. “AARP supports the draft of the Nursing Home COVID-19 Protection and Prevention Act that would help protect the health and save the lives of people in nursing homes and other facilities by supporting testing, personal protective equipment, staffing and more,” said Megan O’Reilly, Vice President of Government Affairs for AARP. “The proposal would also improve public transparency and help protect the rights of residents and their families, adds O’Reilly, calling on Congress “to act immediately to stem the loss of life and slow the spread of the virus.”

In the House Chamber, Rhode Island’s Cicilline, a member of the House Democratic Leadership as Chair of the Democratic Policy and Communications Committee, has also pushed for Congressional funding to stop the spread of COVID-19 in nursing homes. The fifth term Congressman has called for additional funding for the Public Health and Social Services Emergency Fund in the next package for congregate care facilities, including nursing homes. He also signed a letter to HHS Secretary Azar and Administrator Verma, of the Centers for Medicare and Medicaid Services (CMS), urging that HHS and the CMS to ensure that a significant portion of the newly allocated $25 billion for testing in the recently passed CARES Act be utilized for testing in nursing homes and other congregate living facilities.

State-wide Efforts to Combat COVID-19 in Nursing Homes

With Governor Gina Raimondo declaring a state of emergency on March 9, 2020, with the COVID-19 arriving in Rhode Island, the deadly pandemic virus spread quickly throughout the state’s nursing homes. At press time, it has been reported that 75 percent of all related COVID-19 deaths are in nursing homes.

According to Joseph Wendelken, Public Information’s Officer for the Rhode Island Department of Health (RIDOH), the state moved quickly to stop the spread of the COVID-19 virus in the community and in nursing homes. He stated: “We curtailed and then prohibited visiting early on, and we have been doing extensive testing in every assisted living facility in the state. We are doing cyclical testing, meaning that we are continually testing all residents in all homes on a rotating basis. We are giving tailored infection control guidance to specific homes, and we are helping them procure additional PPE.”

Adds Wendelken, RIDOH has established two COVID-19 Specialty Nursing Homes [at Oak Hill Center in Pawtucket and Oakland Grove Health Care Center in Woonsocket] to be a COVID-19 Specialty Nursing Home. “These are centralized facilities to accept patients who are being discharged from the hospital and who are COVID-19 positive but no longer require acute-level care. This strategy allows COVID-19 positive patients leaving the hospital to receive specialized rehabilitation and step-down, post-acute care while reserving hospital beds for patients who need acute-level care,” he said.

On Smith Hill, the Rhode Island House Republican Caucus has recently called for members of the House Committee on Oversight to meet to address the increasing COVID-19 death rate in the state’s nursing and assisted living facilities.

Putting Politics Aside…

With less than 156 days until the upcoming 2020 Presidential election, will S. 3768 reach the Senate floor for a vote. Since the beginning of 2019, more than 350 House-passed bills—including hundreds that have bipartisan support—have been buried by Senate Majority Leader Mitch McConnell (R-Kentucky) in his legislative graveyard. With no Republican Senators supporting Casey and Whitehouse’s COVID-19 bill, will it even reach the Senate floor for a vote?

It’s time for McConnell, who has called himself the “grim reaper” of Democratic legislation, to lay down his deadly scythe, making the safety of millions of residents who reside in the nation’s 15,583 skilled nursing facilities a legislative priority. The GOP Senator from Kentucky, who is in a close Senate race with Democratic opponent Amy McGrath, might consider putting politics aside during a raging COVID-19 pandemic sweeping across the nation to work with Senate Democrats to protect frail residents and nursing home staff. Kentucky voters might view protecting residents against COVID a bipartisan issue.

Senate Aging Committee Tackles COVID-19’s Devastating Impact on Seniors

Published in the Woonsocket Call on May 24, 2020

In the midst of bipartisan bickering on Capitol Hill as to what should be included in the fifth coronavirus (COVID-19) stimulus package, the Senate Aging Committee holds Congress’s first hearing in Senate Russell Office Building 301 on the disproportionate toll the COVID pandemic is having on the nation’s seniors, particularly those who reside in nursing homes.

Adults ages 65 years and older represent two out of every five hospitalizations and eight out of every 10 deaths from the virus. The 1.5 million nursing home residents and seniors residing in group care settings (including assisted living facilities) are especially at risk. Nationwide, residents and workers in nursing homes and other long-term care settings represent more than one-third of all COVID-19 deaths. According to reports, to date more than 34,000 nursing home residents have died from COVID-19.

COVID-19’s Deadly Toll on Seniors

The Senate hearing, “Caring for Seniors Amid the COVID-19 Crisis,” held on Thursday, March 21, 2020, explored what can be done to better protect this vulnerable population. Over two hours, Senators heard testimony from a panel of experts who are supporting older adults in hospitals, nursing homes, home health settings, and the community. (Due to the limited access to the Capitol Complex, the public is only able to view the morning hearing live on the committee’s website at https://www.aging.senate.gov/hearings/caring-for-seniors-amid-the-covid-19-crisis.

“COVID-19 has brought tremendous hardship and tragedy, placing a heavy burden on the frontline workers, straining our healthcare and distribution systems, and imposing a deadly toll on our seniors in particular,” said Senator Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Those in nursing homes and congregate care centers are especially at risk. Nationwide, nursing home residents represent one-third of all coronavirus deaths. In Maine, the toll on nursing home residents is even higher,” adds Collins.

“Our nation is facing the greatest public health crisis it has seen in a century. This terrible virus is causing death and destruction at lightning speed, especially among older Americans who are most vulnerable for complications from COVID-19,” added Ranking Member Bob Casey (D-Pennsylvania). “We have added unprecedented amounts of funding to purchase personal protective equipment, testing and ensure seniors in the community have access to home and community-based services that keep them out of congregate settings, but this is not nearly enough. We cannot stop working we cannot stop legislating, we cannot stop appropriating dollars to help our seniors,” says Casey.

“This unprecedented time calls for equally unprecedented action. The Administration has to do more and Congress has to do more to help our seniors and their families at every turn,” said Casey. During the hearing, the Senator highlighted his bill (S.3768), the Nursing Home COVID-19 Protection and Prevention Act, introduced with Senator Sheldon Whitehouse (D-Rhode Island, which would help mitigate the pandemic’s disproportionate impact on nursing homes by helping states purchase personal protective equipment (PPE) and testing and fund premium pay, overtime and other essential benefits for nursing home workers.

Taking a Look at Universal Testing of Nursing Home Residents

Collins directed her first question at the hearing to Dr. Tamara Konetzka, a professor of health services research at the University of Chicago, who has conducted research on the disproportionate impact of COVID-19 on nursing home residents and staff. She asked Dr. Konetzka to explain how universal testing can protect residents and eventually allow family members to safely visit their loved ones.

“Dr. Konetzka, I want to have you expand a little bit more on what we can do,” said Collins. “I believe that you recommended universal testing for every nursing home resident and staff, which I think is a good idea and have been recommending. How often, however, would you have to do that, and would that allow family members who have been tested to finally be able to visit their loved ones?”

“[I]t is very important to test all residents, and not wait until residents are…symptomatic, because by then it’s too late,” replied Dr. Konetzka. “[W]hat I’ve heard from geriatricians is generally weekly [testing] would be good or at least biweekly, so that residents can then be separated and the transmission can be stopped.”

Collins also emphasized that testing was needed at every long-term care facility, since even the highest rated nursing homes have been susceptible to outbreaks.

At the hearing, Senator Collins called for the release of additional health care provider funding that was made available through the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act.

“[T]he ratings by CMS, the number of stars, has not proven to be a reliable indicator of which nursing homes are safest in this environment. And indeed, one of the worst outbreaks in Maine was at a nursing home that had five stars,” remarked Collins. “[W]hen we hear the statistics, which are so devastating…my heart just goes out not only to these patients, but to their families and to the staff of nursing homes and other assisted living facilities, congregate care settings. They’re all praying that COVID-19 does not find its way into their facility,”she said.

As the chief infectious disease specialist for New York University, Dr. Mark J. Mulligan oversees the treatment of COVID-19 patients at the University’s health system hospitals. At the hearing, he explained that seniors are at increased risk due to aging-related decline of the immune system as well as chronic conditions such as cancer, heart disease, lung disease, and diabetes, and that older adults who reside in nursing homes are the most vulnerable.

Medical Countermeasures to Combat COVID-19

Dr. Mulligan provided an overview of the medical countermeasures under development—diagnostics, monoclonal antibodies, and potential treatments such as remdesivir.

“For physicians, scientists, and leaders, the virus has continued to humble us. There’s so much we don’t know yet about diagnosis, prevention, and treatment,” said Dr. Mulligan. “The nurses and doctors I have worked with are incredibly dedicated and caring, but they have not had the medical countermeasures needed to effectively help many vulnerable seniors who have died of this disease,” he adds.

Finally, the final panelist, Dr. Steven Landers, the President and CEO of Visiting Nurse Association Health Group who oversees a team of 3,000 caregivers that cares for 9,000 people daily, provided a home health perspective on the public health crisis. According to Landers, maintaining this a supply of Personal Protective Equipment (PPE) is both challenging and expensive. “We are using over 17,000 surgical masks and over 3,500 N95 masks each week and we are also using thousands of isolation gowns, gloves, goggles and face shields. We have had to pay 7-10 times the usual prices and reach out to vendors all over the world, vendors who we couldn’t fully vet and verify, sometimes just hoping that shipments would arrive,” he say, calling on Congress to find ways prioritize home health and hospice agencies getting needed PPE.

“I have never seen the system so strained, but I also have never felt prouder of the skilled, compassionate, and courageous people I work with,” he said.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.