Nursing

Nursing homes in Washington state struggled with adequate staffing for years. Then coronavirus struck.

In early March, state inspectors entered a sprawling nursing home in the rural southeast corner of King County where concerns over thin staffing were mounting just as COVID-19 began to spread across the state.

One resident inside the Enumclaw Health and Rehabilitation Center said she hadn’t been bathed for nearly three weeks after she first arrived, according to inspection records. Another described waiting roughly 15 minutes for help after her roommate fell on the floor, while others told of even longer waits for help, lasting 45 minutes or more.

“Sometimes there are so few people in the building,” the resident told inspectors, “if there were an emergency, it would be a calamity.”

Within weeks, coronavirus entered the nursing home, and workers scrambled to help ailing residents, as some got sick themselves. In all, the outbreak killed 26 people, according to the state.

As COVID-19 devastated nursing homes across the state, long-standing staffing woes created a perfect storm at many facilities at a time when workers were needed most. Even though inspectors had routinely found appalling instances of time-strapped staff and patient suffering over the years, Washington state hadn’t raised its standard for adequate staffing.

A Seattle Times analysis found that inspectors cited 118, or more than half, of the state’s skilled nursing facilities a total of 225 times for having insufficient or unqualified staff, according to federal data from 2018 through the start of the pandemic. The state rarely penalized nursing homes for these deficiencies, according to an analysis of thousands of pages of enforcement documents.

Times Watchdog reporting digs deep to expose wrongdoing and hold powerful interests accountable to the public. Support watchdog journalism with a tax-deductible donation to The Seattle Times Investigative Journalism Fund.

In dozens of interviews and a review of inspection reports, workers described poor wages

Continue Reading

NY GOP campaigning on crime, COVID-19 in nursing homes

After suffering a wave of losses in New York in 2018, Republicans are trying to regain seats by campaigning on statewide themes.

Crime and bail. Nursing homes and COVID-19.

Republicans are trying to tie Democratic candidates to Gov. Andrew M. Cuomo’s controversial policies on nursing homes and the pandemic. In some districts, they’re focusing on Cuomo’s business restrictions. Additionally, they’re looking to score points on recent crime spikes and a new law that eliminated bail for most misdemeanors.

The themes are more often used by Republicans challengers taking on Democratic incumbents or competing for an open seat, rather than by GOP incumbents who are running on their records.

For Republicans, it’s a way to push local issues in a state where Republican President Donald Trump is trailing Democrat Joe Biden — and maybe get some Biden supporters to vote GOP on down-ballot races.

“The number one issue that seems to be resonating right now is public safety and that is concerned with the COVID-19 crisis and business closures and that segues into nursing homes,” said Assemb. Anthony Palumbo (R-New Suffolk). He is running for an open Senate district based at the eastern end of Suffolk County against Democrat Laura Ahearn.

On Friday, Republicans rolled out endorsements by 23 police unions.

Democrats counter that these are variations on the same issues their opponents have deployed for years — and that fueled huge Democratic wins two years ago. Further, they said Trump is the single-biggest factor looming over all the contests.

“It’s not surprising to see them use the same themes they’ve used for decades and that led to historic losses” in 2018, said Sen. Michael Gianaris (D-Queens), chairman

Continue Reading

MITRE Issues Independent Coronavirus Commission for Safety and Quality in Nursing Homes Final Report

MCLEAN, Va. & BEDFORD, Mass.–(BUSINESS WIRE)–MITRE announced that its report on the independent Coronavirus Commission for Safety and Quality in Nursing Homes, delivered to the Centers for Medicare & Medicaid Services (CMS) on September 1, 2020, is now available online.

The 186-page report contains 27 principal recommendations, and over 100 accompanying action steps organized into 10 themes: Testing and Screening; Equipment and Personal Protective Equipment (PPE); Cohorting; Visitation; Communication; Workforce Ecosystem – Stopgaps for Resident Safety; Workforce Ecosystem – Strategic Reinforcement; Technical Assistance and Quality Improvement; Facilities; and Nursing Home Data.

“I want to thank the 25 commission members – from infection control experts to nursing leaders to a nursing home resident – for candidly sharing learnings and carefully shaping recommendations that have the potential to improve safety and quality of life in nursing homes immediately,” said Dr. Jay Schnitzer, chief medical and technology officer at MITRE, and moderator of the commission. “Members wrestled with challenging, sometimes competing, issues such as weighing infection control practices against psychosocial needs of residents. These complex issues do not have easy solutions, which made the diverse experience and insights of members integral to developing the recommendations and actions endorsed in the final report.”

CMS announced the formation of the commission on April 30, selecting MITRE to convene, manage, and facilitate its activities, including independently authoring and delivering a report on the commission’s findings and recommendations to the agency, in support of four objectives:

  • Identify best practices for facilities to enable rapid and effective identification and mitigation of transmission of COVID-19 and other infectious diseases in nursing homes
  • Recommend best practices as exemplars of rigorous infection control practices and facility resiliency that can serve as a framework for enhanced oversight and quality monitoring activities
  • Endeavor to identify best practices for improved
Continue Reading

URI cancels spring break; nursing homes to take on testing

KINGSTON, R.I. (AP) — A look at developments related to the coronavirus in New England on Saturday.

RHODE ISLAND

The University of Rhode Island has joined a growing number of U.S. colleges canceling spring break to reduce travel and prevent the spread of the coronavirus.

University officials announced the measure Friday evening, a week after the Faculty Senate approved the change, according to The Providence Journal. It was also supported by university President David Dooley.

Classes will continue from March 22 to 28, the period originally set aside as spring break, and the semester will end on April 27, a week earlier than initially planned.

In a statement announcing the change, officials cited “uncertainty” created by the virus, “and the need to prepare for the likely persistence of existing outbreaks and potential for a new wave of infections.”

Several large universities have announced similar measures in recent weeks, including Ohio State University, the University of Kentucky and the University of Wisconsin at Madison.

___

NEW HAMPSHIRE

Nursing homes in New Hampshire will be in charge of testing their staff for the coronavirus starting next month.

The state Department of Health and Human Services has been operating a surveillance testing program in long term care facilities, but in mid-October will start transitioning that to individual facilities, Commissioner Lori Shibinette said last week.

The state is recommending facilities test all staff during the same week once a month, and then every other week test 10% of staff chosen at random. The state will reimburse them at $100 per test, she said.

Having the nursing homes run their own programs will allow the state to start similar surveillance programs elsewhere, including in assisted living communities and correctional facilities, Shibinette said.

As many as 20 nursing homes once were dealing with coronavirus outbreaks at

Continue Reading

Nursing homes to organize their own COVID testing as state focuses on testing in jails, homeless shelters | Health

The state Department of Health and Human Services has been negotiating with COVID-19 testing labs to run the state’s regular testing of nursing home staff, but announced last week that nursing homes will soon have to organize those tests themselves.

Each facility will make its own contracts with testing labs, Health and Human Services Commissioner Lori Shibinette told nursing home administrators in a phone conference last week, and the state will reimburse up to $100 per test.

“It still provides the funding and the support that is needed to have a good surveillance program,” Shibinette said.

In the event of another outbreak at a nursing home, Shibinette said, the state will again organize and pay for testing. The state provided nursing home administrators with a list of labs that can process tests and contact information for each, and Shibinette expects most nursing homes to have contracts and be running their own testing programs in two weeks.

Shibinette said she hoped turning over that responsibility to nursing homes would free up the state’s capacity to organize regular testing in other congregate living settings, including homeless shelters and jails, to detect more cases early.

The state still dictates how often the tests need to be conducted, what kinds of tests are used and how many staff need to be tested.

Every fourth week, all nursing homes will have to test their entire staff. On the other weeks, nursing homes will randomly pick 10% of their staff to get tested.

But the cost of testing can vary. Dartmouth-Hitchcock Medical Center charges $102 for COVID tests, according to the hospital’s website. A review of COVID test prices by the Peterson Center on Healthcare and the Kaiser Family Foundation https://www.healthsystemtracker.org/brief/covid-19-test-prices-and-payment-policy/ found wide variation in how much tests cost. Some providers charge less than $50 per

Continue Reading