Nightmare is real
The nation’s nursing home regulations must be reevaluated after the pandemic.
For many families, moving an elderly loved one into a nursing home is an emotionally fraught decision. It’s a choice that can be loaded with regret, guilt and shame — even if it’s the best option to meet a vulnerable senior’s needs.
Many facilities ensure residents live with dignity and treat them with respect, but for some seniors, the fear is they will end up alone, imperiled and far from their families as mortality encroaches.
For both groups, the novel coronavirus is a nightmare made real.
The outbreak has spread through the nation’s nursing homes and assisted living facilities like wildfire, stoked by the susceptibility of older adults and those with underlying conditions. The virus has claimed the lives of more than 11,000 nursing home residents nationwide, and these deaths account for more than 40 percent of all COVID-19 related deaths in Texas.
The vulnerability extends beyond seniors themselves to the nursing home industry, which in Texas has been beset with long-standing problems of substandard patient care. Add to that a lack of testing across the state and shortages of personal protective equipment and you’ve got a disaster.
Texas nursing homes consistently rank among the worst in the nation, according to Families For Better Care. In its 2019 report, the Austin-based watchdog group found that 1 in 5 Texas nursing homes were cited over severe deficiencies and that state regulators cited 93 percent of nursing homes for violations of federal or state laws.
The industry also continues to struggle to employ enough licensed nursing staff, and low wages and lack of paid sick leave for nurse aides, who provide most of the direct care to residents, force many of these workers to take jobs at several facilities. This is believed to have contributed to the coronavirus spread.
Texas must do more to safeguard the elderly and keep their families and the public informed.
As of Wednesday, 260 nursing facilities and 93 assisted living facilities in Texas had one or more confirmed COVID-19 cases, according to Texas Health and Human Services. So far, more than 400 people have died as a result.
Tragically, many families were left in the dark until it was too late. Since March 13, Texas wisely has barred visits to nursing homes for anything other than end-of-life reasons. But the state’s restrictions on publicly sharing where outbreaks and deaths were happening — citing health privacy laws — left it up to individual facilities, local health districts or the media to share information.
Fortunately, new federal rules announced last month require nursing homes funded by public insurance programs and regulated by the federal government to inform residents and their families of any COVID-19 cases.
More transparency is needed. Texas continues to be part of the half-dozen or so states — including Louisiana, Pennsylvania and Michigan — that continue to withhold the names of facilities where the coronavirus has spread, limiting a community’s ability to respond.
The new federal rules also don’t apply to assisted living centers, which are overseen by the states.
As part of his report to open Texas, Gov. Greg Abbott included critical recommendations to mitigate the spread of COVID-19 in nursing homes and assisted living facilities, but they are almost exclusively focused on long-term care facilities reporting cases of infection.
Mandatory testing for all nursing facilities, regardless of whether a case has been reported, should be a priority. Most facilities now use checkpoints to screen staff, asking questions and taking temperatures, but the possibility of asymptomatic transmission poses a constant risk.
Harris County began deploying a mobile testing team last week, but limited resources mean it can visit only one facility per day out of more than 500 in the county.
Immediate safety concerns need to be addressed, but once the pandemic has ended, a complete reevaluation of nursing home regulations must take place. Families deserve peace of mind and seniors deserve to be protected.