The Denver Post

Care facilities seek shield from lawsuits with 20,000 dead

- By Bernard Condon, Jim Mustian and Jennifer Peltz

Faced with 20,000 coronaviru­s deaths and counting, the nation’s nursing homes are pushing back against a potential flood of lawsuits with a sweeping lobbying effort to get states to grant them emergency protection from claims of inadequate care.

At least 15 states have enacted laws or governors’ orders that explicitly or apparently provide nursing homes and long-term care facilities some protection from lawsuits arising from the crisis. And in the case of New York, which leads the nation in deaths in such facilities, a lobbying group wrote the first draft of a measure that apparently makes it the only state with specific protection from both civil lawsuits and criminal prosecutio­n.

Now the industry is forging ahead with a campaign to get other states on board with a simple argument: This was an unpreceden­ted crisis and nursing homes should not be liable for events beyond their control, such as shortages of protective equipment and testing, shifting directives from authoritie­s, and sicknesses that have decimated staffs.

“As our care providers make these difficult decisions, they need to know they will not be prosecuted or persecuted,” read a letter sent this month from several major hospital and nursing home groups to their next big goal, California,

where Gov. Gavin Newsom has yet to make a decision. Other states in their sights include Florida, Pennsylvan­ia and Missouri.

Watchdogs, patient advocates and lawyers argue that immunity orders are misguided. At a time when the crisis is laying bare such chronic industry problems as staffing shortages and poor infection control, they say legal liability is the last safety net to keep facilities accountabl­e.

They also contend nursing homes are taking advantage of the crisis to protect their bottom lines. Almost 70% of the nation’s more than 15,000 nursing homes are run by for-profit companies, and hundreds have been bought and sold in recent years by private-equity firms.

“What you’re really looking at is an industry that always wanted immunity and now has the opportunit­y to ask for it under the cloak of saying, ‘Let’s protect our heroes,’ ” said Mike Dark, an attorney for California Advocates for Nursing Home Reform.

“This has very little to do with the hard work being done by health care providers,” he said, “and everything to do with protecting the financial interests of these big operators.”

Nowhere have the industry’s efforts played out more starkly than in New York, which has a fifth of the nation’s known nursing home and long-term care deaths and has had at least seven facilities with outbreaks of 40 deaths or more, including one home in Manhattan that reported 98.

New York’s immunity law signed by Democratic Gov. Andrew Cuomo was drafted by the Greater New

York Hospital Associatio­n, an influentia­l lobbying group for both hospitals and nursing homes that donated more than $1 million to the state Democratic Party in 2018 and has pumped more than $7 million into lobbying over the past three years.

While the law covering both hospital and nursing care workers doesn’t cover intentiona­l misconduct, gross negligence and other such acts, it makes clear those exceptions don’t include “decisions resulting from a resource or staffing shortage.”

Cuomo’s administra­tion said the measure was a necessary part of getting the state’s entire health care apparatus to work together to respond to the crisis.

“It was a decision made on the merits to help ensure we had every available resource to save lives,” said Rich Azzopardi, a senior advisor to Cuomo.

“Suggesting any other motivation is simply grotesque.”

Nationally, the lobbying effort is being led by the American Health Care Associatio­n, which represents nearly all of the nation’s nursing homes and has spent $23 million on lobbying efforts in the past six years.

Other states that have emergency immunity measures are Alabama, Arizona, Connecticu­t, Georgia, Illinois, Kentucky, Massachuse­tts, Michigan, Mississipp­i, New Jersey, Nevada, Rhode Island, Vermont and Wisconsin.

Their provisions vary but largely apply to injuries, deaths and care decisions, sometimes even to property damage. But there are limitation­s: Most make exceptions for gross negligence and willful misconduct, and they generally apply only during the emergency.

Toby Edelman of the

Center for Medicare Advocacy is troubled that homes are getting legal protection­s while family members aren’t being allowed to visit and routine government inspection­s have been scaled back.

“Nobody is looking at what’s happening,” she said, adding that immunity declaratio­ns could make even gross or willful negligence suits harder since homes could argue any deficienci­es were somehow tied to the pandemic.

“Everything can’t be blamed on COVID-19. Other things can happen that are terrible,” she said. “Just to say we’re in this pandemic so anything goes, that seems too far.”

Among the situations for which lawyers say nursing homes should be held to account: Homes that flouted federal guidelines to screen workers, cut off visitation­s and end group activities; those that failed to inform residents and relatives of an outbreak; those that disregarde­d test results; and homes such as one in California, where at least a dozen employees did not show up for work for two straight days, prompting residents to be evacuated.

“If you take the power of suing away from the families, then anything goes,” said Stella Kazantzas, whose husband died in a Massachuse­tts nursing home with the same owners as the home hit by the nation’s first such outbreak near Seattle, which killed 43 people.

While the federal government has yet to release numbers on how the coronaviru­s has ravaged the industry, The Associated Press has been keeping its own tally based on state health department­s and media reports, finding 20,058 deaths in nursing homes and long-term care facilities nationwide.

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