As Death Toll Mounts, Is Enough Being Done to Protect Nursing Homes From COVID-19?

Nursing homes are now very much at the center of COVID-19 outbreak. State and federal health officials are taking steps to stem  illness and death among residents, most of them frail and elderly, and among staff. Many, though, see these efforts as being tardy, halting and poorly executed.

The Philadelphia Inquirer reported today that a Pennsylvania plan to deploy special teams of epidemiologists and other personnel to nursing homes was never fully implemented and that  a similar effort didn’t get started till April.

“This was being touted as the answer to the epidemic. This was the state support we were counting on,” Zachary Shamberg, president and CEO the association that represents nursing homes in the state. “I have to believe if these teams had been ready and prepared, we’d be in much better place today than we are.”

The New York Times has been keeping its own count of nursing home deaths because, the newspapers say, “of the absence of comprehensive data from some states and the federal government.” Today, the newspaper said its tally shows that 27,700 COVID-19-related deaths among nursing home residents or workers, which amounts about a third of the U.S. total. The Times listed all of the nursing homes with 50 or more deaths.  Seven of the 10 facilities with the greatest number of COVID-19-related deaths are in New Jersey; in fact, the top six are in New Jersey: the Paramus Veterans Memorial Home in Paramus, the New Jersey Veterans Memorial Home at Menlo Park in Edison, Bergen New Bridge Medical Center nursing home in Paramus, Andover Subacute and Rehabilitation Center II in Andover, Christian Health Care Center in Wycoff, and Lincoln Park Care Center rehabilitation facility in Lincoln Park. 

Meanwhile, the legal maneuvering is starting to take place. The Associated Press reported in early May that 15 states had taken steps to protect nursing homes from lawsuits.

Critics have wanted to see a stronger response from CMS. This week, the agency published rules that impose new COVID-19-specific reporting requirements on nursing homes. The rules require the first set of data to be submitted by May 17 and then weekly thereafter. The data include the number of cases, deaths, PPE supplies and staffing shortages.

“No nursing home has enough testing, PPE, or staffing to deal with this infection that is actually taking out of a lot of our staff just as try to increase our capabilities,” said Joshua Uy, M.D., during an April 24 panel discussion hosted by the Leonard Davis Institute at Penn. Uy is a geriatrician Penn appointment and medical director of the Renaissance Healthcare and Rehabilitation Center in Philadelphia.