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⭒ News & Notes Archive

September / October 2020

In this Issue

Who’s Fault Is It – Are Nursing Homes to Blame for Their COVID Outbreaks? 

As nursing homes across the country continue to be overrun with coronavirus outbreaks and the number of residents killed by COVID-19 continues to rise, a dispute has emerged over assigning blame. The nursing home industry, unsurprisingly, has been pushing a narrative that nursing homes are “victims” of coronavirus and blameless for the outbreaks in their buildings. The problem with the industry narrative is that it conflates COVID “incidence” (having one case of COVID-19 in a facility) with COVID “extent” (the size of the outbreak within a facility, once it had a case). While incidence is very likely associated with community outbreaks, it is after the virus has entered a nursing home when the differences in quality of care among facilities will matter. Good and bad facilities both have COVID outbreaks; but extensive COVID spread is much more likely to occur in bad facilities.
CLICK HERE to download the report.

Federal Memo Pushes Restoration
of Nursing Home Visits

On September 17, the Centers for Medicare and Medicaid Services (CMS) released a memo to the states, substantially restoring visitation in nursing homes.  CMS is requiring facilities to permit visitation whenever a facility has had no new COVID outbreaks for 14 days and the community positivity rate is less than 10%.  Facilities required to permit visitation are encouraged to have outdoor visitation, weather permitting, but are also required to accommodate indoor visitation, including in resident rooms, when outdoor visits are unavailable. These new rules may still in some cases conflict with more draconian procedures imposed by county boards of health, but provide crucial leverage to help get life-saving visitors into facilities. 

If you know of any facilities that continue to impose absolute bars on visitation in California, please contact CANHR.

White House Commission Urges Feds for More Resources (But Not Enforcement) in Nursing Homes

The White House’s Coronavirus Commission on Safety and Quality in Nursing Homes released an extensive report reviewing lessons learned from the COVID-19 pandemic and making recommendations to improve safety in nursing homes related to infection control.  The report sets forth dozens of potential “action steps” for the Centers for Medicare and Medicaid Services (CMS) and other federal and state agencies to take to foster better infection control and improve resident safety in nursing homes through more extensive testing, more balanced approaches to visitation, and better support for staff and caregivers.  

The Report is just as notable for what it does not contain. Commission member Eric Carlson of Justice in Aging refused to endorse the report, instead writing a three-page rebuke of the report’s failures.  Eric writes “[the report] recommends dozens of obligations for the federal government, but does little to set higher standards for nursing homes, or to ensure nursing home accountability.”  

Governor Newsom Kills Bill to Keep Nursing Home Residents Safe

On September 25, Governor Newsom vetoed SB 1207, a critically important bill by Senator Hannah-Beth Jackson that would have required skilled nursing facilities to have an alternative source of power to protect resident health and safety and maintain safe temperatures for at least 96 hours during any type of power outage, events that have become especially common during California’s disastrous wildfires. 

Senator Jackson’s bill – The Nursing Home Resident Safety Act – had near unanimous, bipartisan support in the Legislature and was a priority measure for the Senate Wildfire Working Group. SB 1207 was co-sponsored by CANHR and Long Term Care Ombudsman Services of San Luis Obispo County and supported by many advocacy, human service and governmental organizations.

Echoing the specious claims of nursing home lobbyists, the Governor’s veto message states that the federal standards SB 1207 would adopt are “unclear.” What is clear is that the California Department of Public Health remains firmly in the grip of the nursing home industry it is supposed to regulate.

Read CANHR’s September 28 press release on the veto

CANHR Pushes for Long Term Care Voter Protections

Many California residents of long term care facilities face the prospect that they will be disenfranchised from voting in the upcoming election which is above all a referendum on the nation’s public health response to the COVID pandemic. 

Under a 2016 CMS and HHS rule, 42 CFR §483.10, residents in long term care facilities have “the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights and to be supported by the facility in the exercise of his or her rights.” Further, facilities “must ensure” that residents can exercise their rights as residents of the facility, and as a citizen or resident of the U.S.   

During the pandemic, long term care residents are routinely warned not to leave facilities or face being locked out as a contagion control, and visitors who might assist with absentee ballots or voting by mail are not permitted entry. Although voting by mail is the safest means for long term care residents to cast their ballots, facilities throughout the state have made little or no effort to assist residents to participate in the election by this means.

CANHR has sent letters to regulators for nursing homes and assisted living facilities urging that they take action to protect long term care residents’ right to participate in the election. 

Dysfunction and Dissent: Inside L.A. County’s Troubled Nursing Home Oversight Division

That’s the title of an eye-opening expose published by Capital & Main on September 30 about inspectors at the Health Facilities Inspection Division of the Los Angeles County Public Health Department calling for leadership change due to concerns about incompetent leaders endangering vulnerable nursing home residents. Through a contract with the California Department of Public Health, the Health Facilities Inspection Division (HFID) is responsible for regulating nursing homes in Los Angeles County, a mission at which it has failed miserably for decades. According to the article, many HFID employees have risen up in protest over these failures, with one of them stating that its chief does not care whether nursing home residents get sick or die. A nurse inspector said of nursing home residents, “We were hired to protect them and make sure they receive the quality of care they deserve. And we feel that they failed them.” Another inspector wrote that “many SNF residents are and will continue to suffer and die without HFID repairs.” A companion article published on the same day – Can L.A. County Turn Around Its Nursing Home Debacle? – examines actions needed to reform the dysfunctional Health Facilities Inspection Division.

Zoom Town Hall: Resident Rights:
Voting, Visitation, and More!

On October 13th at 11:00am CANHR will be hosting a town hall for California residents of long term care, their families, and their friends, addressing key developments including voting rights during the pandemic, rights to visit and to exit facilities, and how to craft effective complaints to regulators to safeguard these rights. Speakers will include CANHR Executive Director Patricia McGinnis, CANHR staff attorneys Tony Chicotel and Mike Dark, and CANHR Program Director Julie Pollock.

Registration is free and will guarantee your attendance slot is available. 

CANHR COVID-19 News & Resources

If you have not already done so, please check out CANHR’s COVID-19 website. The rapidly evolving website has hundreds of pages devoted to COVID-19 information, news and resources related to long term care. It contains CANHR alerts and recommendations, information on visitation rights, state and federal directives, links to outbreak data, media stories, webinar recordings and much more. Also visit our Visitation Saves Lives website.

Oppose Immunity for Nursing Homes
that Harm Residents

Please consider signing this online petition by The National Consumer Voice for Quality Long-Term Care to oppose nursing homes escaping accountability for negligent care. A brief summary in their words:

The “Safe to Work Act,” recently introduced in the US Senate by Senator Mitch McConnell, would allow nursing homes to escape accountability for negligent care that harms or kills nursing home residents. This immunity would extend for five years and apply to all harm to nursing home residents, even if it is not related to COVID-19.