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The Washington PostDemocracy Dies in Darkness

Democratic senators highlight continuing toll of covid-19 in nursing homes

Citing federal data, they say the Trump administration did too little as the pandemic spiked in the Sun Belt this summer.

Residents at the Southern Pines nursing home in Warner Robins, Ga., are separated and wear face coverings during their daily bingo game, in June. Nursing home cases of covid-19 spiked in the Sun Belt over the summer. (John Bazemore/AP)

A new report by two Democratic senators documents the troubles that continue to plague U.S. nursing homes as they try to deal with the coronavirus pandemic, and it faults the Trump administration for not providing adequate assistance, even after the devastating effects of the disease became clear last spring.

The death toll among nursing home residents rose throughout the summer, and the report, released Tuesday, found that shortages of personal protective equipment grew more acute between July 1 and the end of August.

The period under study saw a sharp spike in coronavirus infections in the Sun Belt states, and neither nursing homes nor public health agencies were equipped to fend off covid-19 despite the lessons that became evident as the coronavirus swept through Northeastern facilities in April and May.

Nursing homes in the Sun Belt had months to prepare for rising coronavirus cases. They still weren’t ready.

About 20 percent of nursing homes are dealing with staff shortages, in part because of the ravages of the pandemic on employees, including 331 who died in July and August, said the report, commissioned by Democratic Sens. Robert P. Casey Jr. (Pa.) and Ron Wyden (Ore.) and relying largely on the administration’s own data.

The report stated that 16,487 residents died during that same period — and cited an analysis by The Washington Post that found that Black nursing home residents have been disproportionately affected.

Near birthplace of Martin Luther King Jr., a predominantly Black nursing home tries to heal after outbreak

About 50,000 nursing home residents have died since the pandemic began.

The report faulted the administration for incomplete data collection, inadequate shipments of personal protective equipment, a failure to provide quick and reliable testing for the novel coronavirus, and insufficient financial disbursements to address staff shortages.

“This report lays bare the devastating cost that American families have paid as a result of the Trump administration’s incompetency and Republican inaction,” Casey said Tuesday. “The crisis in our nursing homes, which residents and workers and their families are experiencing every day, demands immediate action.”

The authors of the report, which cited “the president’s flippant disregard for medical science and our nation’s most vulnerable people,” were especially critical of the administration’s policies on data collection and testing.

“More than eight months into the pandemic, the Trump Administration’s data on nursing homes still fails to fully capture the devastating toll of COVID-19,” it says, “as there is no required data collection whatsoever on case counts and deaths that occurred prior to May 1. Further, alarmingly, the Trump Administration is still not collecting information that would shed light on the disparate impact that the pandemic is having on Black and Hispanic/Latinx individuals and other people of color in nursing homes.”

It wasn’t until Aug. 25 that the Centers for Medicare and Medicaid Services announced it would require testing for residents and staff. And the test kits being distributed by CMS, although promising fast results, rely on antigen testing that can be less reliable than other methods.

Citing CMS data, the senators’ report found that, “as of August 30, more than 700 nursing homes — nearly five percent of the nation’s total — reported that they have no ability to test all residents or workers within the next seven days.”

Last week, a panel convened by CMS released a set of recommendations calling on the Trump administration to provide extra funds to support more comprehensive testing at nursing homes, the purchase of PPE, more thorough training on infection control and the hiring of more staff at better pay.

That study also called for a national policy designed to allow safe visits by family members of residents, which some states have barred since last spring. On Friday, CMS issued guidance to nursing homes on visitation, to the applause of advocates.

“While we must remain steadfast in our fight to shield nursing home residents from this virus, it is becoming clear that prolonged isolation and separation from family is also taking a deadly toll on our aging loved ones,” CMS head Seema Verma said.

While endorsing the recommendations of the CMS panel, critics said it should have also called for greater accountability on the part of nursing homes, where, they say, lax enforcement, sloppy procedures and low pay led to corner-cutting and avoidable infections and deaths.

Task force says nursing homes need more aid. Critics say industry should step up.

The Casey-Wyden report also skirts issues of accountability and enforcement.

In addition to recommending more funds for testing, PPE and staff, their report urges Congress to appropriate additional funds in conjunction with “a national action plan, drawing on best practices in infection control and prevention, including cohorting and surge teams.”

They also advocate higher levels of support for home- and community-based health care as a way of helping people stay out of nursing homes and thereby reducing risk of infection.

Coronavirus’ impact on America’s nursing homes

The Washington Post is examining the deadly effects of the coronavirus on nursing home residents and workers

51 lives: Portraits of the pandemic’s tragic toll on U.S. nursing homes

Reuniting: With vaccinations, nursing home visits resume but are tinged with grief and fear

Perspective: I work in a nursing home. Here’s why my colleagues are skipping the vaccine.

Vaccinations: Nursing home workers don’t want the vaccine. What facilities are doing about it?

Regulations: CMS imposed few penalties at nursing homes despite promises of tough enforcement

Black nursing homes: Residents in majority-Black nursing homes suffer higher coronavirus death rates

Misusing federal money: Funding from the Cares Act went to nursing homes with deadly breakdowns in patient care

Violations: Nursing home chains violated federal standards meant to stop covid spread

Tell the Post: Do you work at a nursing home, or have a loved one at a long-term care facility?