Hurd on the Hill: Why Were Our Seniors Left Vulnerable?

As the COVID-19 pandemic began to spread from outside our borders into the contiguous United States, there was a lot of uncertainty about the characteristics of the virus. After studying trends from other countries who were largely hit with the virus before we were, it was clear that, like many other viral diseases, COVID-19 disproportionately affects our senior citizens.

This was evident during the early weeks of the pandemic outbreak in the U.S., as one of the first epicenters of the pandemic developed in Kirkland, Washington at a nursing home. This would not be the only outbreak at one of these facilities, and as the pandemic progressed we discovered that nursing homes and long-term care facilities were ill-equipped to keep their residents safe from what’s been called the “silent enemy.” Unfortunately, this was even the case in our district.

The Centers for Medicare and Medicaid Services (CMS), provide quality ratings for each of the nation's approximately 16,000 Medicare and Medicaid-certified nursing homes. Each facility is rated from a low of one star to a high of five stars based on three critical areas: health inspection results, quality measures and staffing levels. An overall rating is also provided after consideration of five areas: fire safety, health inspection, quality measures, staffing and penalties.

There are 99 nursing homes or long-term care facilities within 50 miles of San Antonio, and last year only 3 were given a 5-star rating by CMS. This reality is not just in Texas either. A report publicly released by the Government Accountability Office in June of last year showed a rise in abuse at nursing home facilities. From 2013 to 2017, abuse citations doubled.

Staggering statistics like these depict a significant deficiency in a sector of our health care system and are what led to the many COVID-19 outbreaks in long-term care facilities. In several states, like Massachusetts, more than half of those who have died from the virus were residents in nursing or long-term care homes. In San Antonio, there have been COVID-19 outbreaks in at least 5 nursing homes that have infected residents and staff, including Southeast Nursing and Rehabilitation Center, where an outbreak killed 19 people.

These stories led Congress to take action, by appropriating $200 million in the CARES Act to specifically aid these facilities to get a handle on the outbreaks. It also led many state executives, including Texas’ governor, to order the testing of all nursing home residents and staff.

When families make the difficult decision to put their loved ones into a long-term care facility, they should only worry about when they will be able visit them, not their level of care or whether they will be safe from a pandemic.

As we begin to climb out of this pandemic, we must think about advancement not just recovery. We have to come out of this better than before, not just get back to where we were. This includes doing an analysis on what went wrong at nursing homes and what needs to be done moving forward to prevent from this from happening again. It’s not a matter of if another pandemic will happen, but when. Our nursing and long-term care homes must be better prepared.

This Congress, I signed onto H.R. 647, the Palliative Care and Hospice Education and Training Act. This bill requires the Department of Health and Human Services to take actions to improve palliative and hospice care training of health professionals. While this is one thing to be done, it is not going to fix the whole problem. We have to do more and get serious about taking care of our elderly.

COVID-19 didn’t start in a nursing home, it was brought in. There need to be updates to standards of care such as cleanliness, because it is what prevents disease spread amongst an already incredibly at-risk population. Currently, surveys are conducted every year by state surveyors, but there are plans to decrease surveys to every 2 years. If the conditions we have now are based on yearly surveys, imagine what happens when the system changes to biannual. These are the things we have to address.

Our moms, dads and grandparents took care of us for most of our lives, and now it’s our turn to take care of them.

 

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