- Commitment to Justice: A Statement by Center for Medicare Advocacy Executive Director Judith Stein
- Center for Medicare Advocacy Submits Comments on CMS COVID-19 Rule
- How Many Nursing Home Residents Have Died of Covid-19?
- COVID-19: Advocating for Nursing Home Residents – A webinar series
Commitment to Justice: A Statement by Center for Medicare Advocacy Executive Director Judith Stein
Black Lives Matter. The Center for Medicare Advocacy mourns for George Floyd and for the named and unnamed people of color who have been murdered or harmed in countless ways in our country. We mourn for our country. We protest.
For more than thirty years, the mission of the Center has been to ensure fair access to Medicare and health care for all. FAIR. FOR ALL. We can’t separate ourselves from the greater fight for fairness, for justice – for all.
When Rep. John Lewis spoke at the Center’s 2019 National Voices of Medicare Summit, he urged us to always fight against injustice and not settle for the status quo, no matter how challenging the process. “Make a way out of no way,” he urged. “When you see something that is not right, not moral, not just, you have a moral obligation to say something, to do something.”
We hear this call to action.
We will work to make a way through these dark times of hate, illness, and despair. We will take risks to take back our country for people who care for one another – not regardless of our different skin colors, religion, sexual and gender identity – but in honor and love for our differences. We stand against white supremacy, against prejudice. Against fear. We stand for our one human community.
Judith Stein, Esq.
Executive Director
Center for Medicare Advocacy
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Center for Medicare Advocacy Submits Comments on CMS COVID-19 Rule
On June 1, 2020, the Center for Medicare Advocacy submitted comments to the Centers for Medicare & Medicaid Services’ (CMS) Interim Final Rule with Comment: Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (CMS-1744-IFC). The rule, at 85 Federal Register 19230 (April 6, 2020), is available here. While the Interim Final Rule contains only some of the waivers and other flexibilities CMS has issued in response to the COVID-19 pandemic, the Center included comments on CMS’s waivers more generally.
As noted in the Center’s comments, “From a beneficiary standpoint, some of these rule changes and waivers have improved eligibility for and access to services (such as waiver of the 3-day inpatient stay and extended coverage allowance re: skilled nursing facilities). We urge CMS to expand such changes after the end of the Public Health Emergency (PHE).
Some changes can improve access to care for beneficiaries, such as broadened telehealth coverage, but should not be used as a substitute for necessary in-person visits, nor should they be used to further weaken Medicare Advantage network adequacy standards […].
Other changes give us great pause, such as those aimed at easing so-called “burdens” on providers – like suspending certain reporting requirements – and CMS’s suspension of many oversight activities. We urge CMS to reinstate these provisions as soon as possible.”
- The Center’s full comments are available at: https://medicareadvocacy.org/center-comments-on-policy-and-regulatory-revisions-in-response-to-covid-19/
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How Many Nursing Home Residents Have Died of Covid-19?
On June 1, 2020, the Centers for Medicare & Medicaid Services (CMS) reported that the 12,500 nursing facilities (approximately 80% of facilities nationwide) sending data to the Centers for Disease Control and Prevention reported, as of May 24, 2020, that 25,923 residents and 449 staff (totaling 26,372 people) have died of COVID-19.[1] The Kaiser Family Foundation reported a considerably higher number: 39,039 deaths from COVID-19 occurring in nursing facilities in 47 states, as of May 29, 2020.[2]
Large as both numbers are, they are still likely to be understated. Many nursing home residents who die from COVID-19 did not have symptoms of elevated temperature, coughs, or respiratory symptoms and may not have been tested for COVID-19. A study of residents at the Washington State nursing facility, where the coronavirus was first identified, found that more than half the residents who tested positive did not have any symptoms.[3] Other reports have also found that older people may be lethargic, sleep more, stop eating, become dizzy, or become disoriented and unable to speak, but do not have more typical symptoms of COVID-19.[4]
In final rules published in 2016, CMS described infection prevention control as a “critical” issue, with failures in infection control leading to millions of infections each year, hundreds of thousands of residents’ hospitalizations and deaths, and billions of dollars in health care costs. 81 Fed. Reg. 68688, 68808 (Oct. 4, 2016), https://www.govinfo.gov/content/pkg/FR-2016-10-04/pdf/2016-23503.pdf. Strengthening longstanding infection prevention and control standards was a key requirement of the 2016 rules.
Instead of rolling back nursing home regulations, CMS needs to impose meaningful and appropriate sanctions when facilities fail to meet standards for infection prevention and control. Unless the regulatory system treats these essential standards seriously, as the life-and-death requirements they are, we risk seeing repeated loss of residents’ lives.
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[1] CMS, Nursing Home COVID-19 Data
[2] https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/#stateleveldata
[3] Melissa M. Arons, et al, “Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility,” The New England Journal of Medicine (Apr. 24, 2020), https://www.nejm.org/doi/full/10.1056/NEJMoa2008457?query=featured_home.
[4] Judith Graham, “Seniors With COVI-19 Show Unusual Symptoms, Doctors Say,” Kaiser Health News (Apr. 24, 2020), https://khn.org/news/seniors-with-covid-19-show-unusual-symptoms-doctors-say/.
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COVID-19: Advocating for Nursing Home Residents – A Webinar Series
Featuring Center for Medicare Advocacy Senior Policy Attorney Toby S. Edelman.
The landscape of COVID-19 response in nursing homes continues to evolve rapidly at the federal and state levels. Join the Consumer Voice, Center for Medicare Advocacy, Long Term Care Community Coalition and Justice in Aging as we review the latest updates, issuances from CMS, legislation, and strategies for advocates and families.
This series of webinars is focused on the impact of COVID-19 on long-term care facilities and its residents. Webinars scheduled for Jun 5, 2020 02:00 PM; Jun 12, 2020 02:00 PM; Jun 19, 2020 02:00 PM; Jun 26, 2020 02:00 PM 9All times Eastern).
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