“The Devastating Impact of the Coronavirus Crisis in America’s Nursing Homes,”[1] a June 11 briefing by the Select Committee on COVID of the House Committee on Oversight and Reform, identified nursing homes’ longstanding problems in staffing levels and infection control, as well as the failure of the federal government to take a strong leadership position in confronting the coronavirus pandemic. Based on the Briefing,[2] the Committee on June 16 launched an investigation into the Centers for Medicare & Medicaid Services’s lax oversight of the pandemic and the Trump Administration’s failure to provide testing, supplies, and personal protective equipment to nursing facilities.[3] Chairman Clyburn said, “‘Deregulation and lax enforcement of infection control violations by CMS – both before and during the pandemic – may have contributed to the spread of the virus.’”
The Committee also sent letters to five for-profit nursing home chains (Genesis HealthCare, Life Care Centers of America, Ensign Group, SavaSenior Care, and Consulate Health Care) that provide care to more than 80,000 residents in 40 states and where hundreds of residents have died. The letters seek information about “coronavirus cases and deaths, testing, personal protective equipment, staffing levels and pay, legal violations, and efforts to prevent further infections” as well as information about “the use of federal funds by nursing homes during the pandemic.”
Five witnesses testified at the Committee’s June 11 Briefing: Alison Lolley, daughter of a Louisiana nursing home resident who died of COVID-19 in April; Chris Brown, a certified nursing assistant (CNA) at a Chicago nursing facility; Eric Carlson, Directing Attorney, Justice in Aging; Phil Kerpen, President, American Commitment; and David Grabowski, Professor of Health Care Policy, Harvard Medical School.
The two witnesses closest to day-to-day activities in nursing facilities – Ms. Lolley and Mr. Brown – testified that low staffing levels were a problem even before the pandemic. Ms. Lolley described her mother’s disheveled appearance and statements that she had not been fed, following the March ban on visitors. Mr. Brown, a CNA for 10 years, testified that facilities were and remain understaffed, temporary workers do not have sufficient training or skills to provide necessary care to residents, and facilities continue to lack sufficient tests (he has still not yet been tested for COVID-19) and personal protective equipment (PPE).
The witnesses also generally agreed that the federal government needs to take a leading role in ensuring adequate tests and PPE, but had not done so. A third overriding concern, voiced strongly by Dr. Grabowski, was that data on COVID-19 are inadequate. CMS has required nursing facilities to report COVID-19 deaths and problems since May 8,[4] not since the beginning of the pandemic. “Good public health,” he said, “requires good data.”
T. Edelman
[1] https://oversight.house.gov/legislation/briefings/select-subcommittee-briefing-on-the-devastating-impact-of-the-coronavirus.
[2] The Committee issued a Press Release on June 12, describing key concerns raised by the Briefing. “Select Committee Briefing Confirms Urgent Need for Federal Action to Protect Nursing Homes from Coronavirus” (Press Release, Jun. 12, 2020), https://oversight.house.gov/news/press-releases/select-committee-briefing-confirms-urgent-need-for-federal-action-to-protect.
[3] Select Subcommittee on the Coronavirus Crisis, “Clyburn Launches Sweeping Investigation into Widespread Coronavirus Deaths in Nursing Homes” (Press Release, Jun. 16, 2020), https://coronavirus.house.gov/news/press-releases/clyburn-launches-sweeping-investigation-widespread-coronavirus-deaths-nursing.
[4] Interim final rule, CMS, “Medicare and Medicaid Programs, Basic Health Program, and Exchanges: Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program,” CMS-5531-IFC, 85 Fed. Reg. 27550 (May 8, 2020), https://www.govinfo.gov/content/pkg/FR-2020-05-08/pdf/2020-09608.pdf.