Blame game with partisan overtones
A grim blame game with partisan overtones is breaking out over Covid-19 deaths among nursing home residents, a tiny slice of the population that represents a shockingly high proportion of Americans who have perished in the pandemic.
The Trump administration has been pointing to a segment of the industry – facilities with low federal ratings for infection control– and to some Democratic governors who required nursing homes to take recovering coronavirus patients.
Homes that followed federal infection control guidelines were largely able to contain the virus, asserts Seema Verma, head of the Centers for Medicare and Medicaid Services, or CMS, which sets standards and pays the bills. ‘‘Trying to finger-point and blame the federal government is absolutely ridiculous,’’ she says.
Verma says data collected by her agency suggest a connection between low ratings on safety inspections and Covid-19 outbreaks. But several academic researchers say their own work has found no such link.
Advocates for the elderly say the federal government hasn’t provided needed virus testing and sufficient protective gear to allow nursing homes to operate safely.
A White House directive to test all residents and staff has been met with an uneven response.
‘‘The lack of federal coordination certainly has impeded facilities’ ability to identify infected persons and to provide care,’’ Eric Carlson of the advocacy group Justice in Aging, told lawmakers. Democrats are critical of the Trump administration response. ‘‘We need action,’’ says Senator Bob Casey.
Nationwide, more than 45,500 residents and staff have died from coronavirus outbreaks at nursing homes and other long-term care facilities. That’s about 40 per cent of more than 115,000 total deaths. Nursing home residents are less than 1 per cent of the population.
It’s a sensitive election-year issue for President Donald Trump, who’s trying to hang on to support from older voters. With more coronavirus legislation possible this year, congressional Democrats are pressing for a national testing plan and additional resources for nursing homes. Republicans are mainly seconding the administration’s arguments.
Republican Steve Scalise of Louisiana blamed New York Democratic Gov. Andrew Cuomo for the high numbers of deaths in his state. A since-rescinded state directive that nursing homes had to accept recovering coronavirus patients ‘‘ended up being a death sentence’’ in New York and several states with similar policies, Scalise said.
But Harvard researcher David Grabowski, who serves on a nonpartisan commission advising Congress about Medicare, says neither state policies, nor ‘‘bad apples’’ among nursing homes, have driven the outbreak.
Instead, Grabowski says it’s simpler: Because the virus can be spread by people who show no symptoms, that means if it’s already in a community, the staff can unwittingly bring it into the nursing home. He proposed a federal effort to regularly test staff and residents, along with greater supplies of PPE. He said his research, along with studies by Brown University and University of Chicago did not find a relationship between facilities with low federal ratings and Covid outbreaks.
Verma said her agency has been on top of things from the beginning, issuing numerous safety guidelines, setting reporting requirements, and providing Medicare payment for testing. She says states have money from the federal government that they can use to support testing of staff.
The nursing home industry says just one-time testing for every resident and staffer would cost $440 million, and facilities struggling financially would not be able to bear the expense of regular staff testing. -AP