What Can and Should Be Done to Reduce the COVID-19 Disease, Death in Nursing Homes?

Jay Schnitzer

As of yesterday, CDC’s official tally of COVID-19 deaths was 119,055.  The estimates vary quite a bit, but there’s no question that a sizable proportion of those deaths have occurred among residents of nursing homes and other long-term facilities. As of June 18, the Kaiser Family Foundation’s count was 50,185 in 41 states. In early June, preliminary data from CMS showed 29,457 deaths in nursing home from COVID-19.

CMS and the CDC have issued COVID-19 guidelines for nursing homes. But the way that COVID-19 has played out in the nation's nursing homes is a complex situation, often with human suffering attached. A story in today's New York Times reports that some nursing homes have cleared out residents who don't have COVID-19 because the reimbursment rate for COVID-19 is higher. "With nursing homes not allowing visitors, there is less outside scrutiny of their practices," reports the newspaper. "Fifteen state-funded ombudsmaen said in intereviews tht some homes appear to be taking advantage of that void to evict vulnerable residents." 

In late April, CMS announced that it would be setting up an independent Coronavirus Commission for Safety and Quality in Nursing Homes to examine COVID-19-related issues in depth, including identification of best practices for rapid identification and mitigation of transmission and for care delivery. The MITRE Corporation, a federal contractor and research organization with offices in Bedford, Massachusetts, and McLean, Virginia, was hired to set up and run the commission.

Related: In Harm's Way: Nursing Homes in the COVID-19 Pandemic

Last week, CMS and MITRE announced that it had picked the 25 members of the commission out of a pool of 800 applicants. Jay Schnitzer, Ph.D., M.D., MITRE’s chief technology and medical officer, will serve as the commissioner’s moderator.

Here is a list of the 25 members of the commission:

• Roya Agahi, RN, MS HCM, WCC; Chief Nursing Officer, formerly of NYC Health + Hospitals, soon to be of CareRite, New York

• Lisa M. Brown, PhD, ABPP; Professor of Psychology, Palo Alto University, California

• Mark Burket, CEO, Platte Health Center Avera, South Dakota

• Eric M. Carlson, JD; Directing Attorney, Justice in Aging, California

• Michelle Dionne-Vahalik, DNP, RN; Associate Commissioner, State Health and Human Services Commission, Texas

• Debra Fournier, MSB, BSN, ANCC RN-BC, LNHA, CHD, CPHQ; COO, Veterans’ Homes, Maine

• Terry T. Fulmer, PhD, RN, FAAN; President, The John A. Hartford Foundation, New York

• Candace S. Goehring, MN, RN; Director, State Department of Social and Health Services, Aging and Long-Term Support Administration, Washington

• David C. Grabowski, PhD; Professor of Healthcare Policy, Harvard University, Massachusetts

• Camille Rochelle Jordan, RN, BSN, MSN, APRN, FNP-C, CDP; Senior Vice President of Clinical Operations & Innovations, Signature Healthcare, Kentucky

•  Jessica Kalender-Rich, MD, CMD, AGSF, FAAHPM, FACP; Medical Director, Post-Acute Care, University of Kansas Health System, Kansas

• Marshall Barry Kapp, JD, MPH; Professor Emeritus of Law, Florida State University, Florida

• Morgan Jane Katz, MD, MHS; Assistant Professor of Medicine, Johns Hopkins University, Maryland

• Beverley L. Laubert, MA; State Long-Term Care Ombudsman, State Department of Aging, Ohio

• Rosie D. Lyles, MD, MHA, MSc, FACA; Director of Clinical Affairs, Medline Industries, Illinois

•  Jeannee Parker Martin, MPH, BSN; President and CEO, LeadingAge California

• G. Adam Mayle, CHFM, CHC, CHE; Administrative Director of Facilities, Memorial Healthcare System, Florida

• David A. Nace, MD, MPH, CMD; President, AMDA – The Society for Post-Acute and Long-Term Care Medicine, Pennsylvania

• Lori Porter, LNHA, CNA; CEO, National Association of Health Care Assistants, Missouri

• Neil Pruitt, Jr., MBA, MHA, LNHA; Chairman and CEO, PruittHealth, Inc., Georgia

• Penelope Ann Shaw, PhD; Nursing Home Resident and Advocate, Braintree Manor Healthcare, Massachusetts

• Lori O. Smetanka, JD; Executive Director, National Consumer Voice for Quality Long-Term Care, Maryland

• Janet Snipes, LNHA; Executive Director, Holly Heights Nursing Home, Colorado

• Patricia W. Stone, PhD, MPH, FAAN, RN, CIC; Professor of Health Policy in Nursing, Columbia University, New York

• Dallas Taylor, BSN, RN; Director of Nursing, Eliza Bryant Village, Ohio