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A survey by AARP of registered voters age 18+ in Virginia showed overwhelming support for a variety of measures to hold nursing homes accountable. More than 7-in-10 (71%) of all voters surveyed support the establishment of minimum hourly staffing thresholds, with support consistent across genders, age groups, and regions. This proposal is supported by almost 8-in-10 (78%) moderate voters and nearly two-thirds (62%) of conservative voters. You must take action to ensure residents receive the care they need by establishing minimum hourly staffing standards. A number of states have taken steps including public reporting of nursing homes and assisted living facilities with COVID-19 cases, increased testing, more PPE, hazard pay for staff, and mobilizing the state National Guard units to support facilities. At the federal level, the Centers for Medicare & Medicaid Services is requiring nursing homes to report confirmed cases of COVID-19 among residents and staff as well as notify residents and families.
The CDC publishes a Nursing Home COVID-19 Data Dashboard and Nursing Home Vaccination Data Dashboard that are updated weekly and include several key data points at the state and national level. The rate of resident cases is up 63% and the rate of staff cases is up 70% in the week ending December 4, compared to the last week of the dashboard. AARP sent a letter to the Centers for Medicare & Medicaid Services asking officials to strengthen enforcement of quality standards to protect the 1.3 million Americans living in nursing homes.
AARP Urges Feds to Strengthen Nursing Home Protections
Make sure that families get the information they need about their loved ones including knowing their rights when residents are transferred or discharged because of COVID-19. Many Americans think about retirement as the last big plan they’ll ever have to make, but they’ll need to plan to protect themselves against the risk of making poor decisions later in life. In “Make a Plan While You Can,” AARP Bulletin’s personal finance expert offers advice from making decisions on independent or assisted living to designating power of attorney on major medical decisions in case you can’t make them yourself. Men represent 2 out of 5 of the more than 40 million unpaid family caregivers in the U.S., but the role of male caregivers remains hidden. In honor of National Family Caregivers Month, AARP Bulletinreveals why these 16 million men are the best-kept secret of caregivers in America, and why they are breaking stereotypes of the typical caregiver. Also, in this month’s issue, from putting soap in a nylon stocking for a non-slippery soap to using glow tape for safe walks in the house at night, AARP Bulletin offers six clever and low-cost ways caregivers can make everyday tasks easier.
With a winter surge possibly already underway, more than 600,000 residents and more than 1.5 million staff are NOT up to date on vaccinations, leaving them without full protection from COVID-19. “AARP thanks the Centers for Medicare & Medicaid Services for providing updated guidance that allows easier in-person visitation at nursing homes while continuing to emphasize infection prevention and control practices for facilities, visitors and others. Please join us in urging state lawmakers to take immediate action to ensure that staffing levels in long-term care facilities are adequate. The declining number of cases in long-term care settings means many facilities can resume indoor visitation. Medicare certified skilled-nursing facilities must meet additional criteria required by the Centers for Medicare and Medicaid Services.
Making nursing homes safe to visit again
At the national level, the CMS data source gives a significant undercount of the number of cases and deaths before June 2020, compared to other sources that were reporting in real-time. Nancy LeaMond is the chief advocacy and engagement officer for AARP, widely seen as one of the most powerful advocacy organizations. Leading its government affairs and legislative campaigns, she has the responsibility of driving the organization’s social mission on behalf of Americans 50-plus and their families.
She also manages public education, volunteerism, multicultural outreach and engagement, and she directs major AARP initiatives that include supporting family caregivers through advocacy, education and innovative programs, and expanding AARP’s local footprint in communities across the country. Even with the loosening of restrictions in North Carolina, advocates for nursing home residents report that many facilities have limited hours and access, even in incidences when both the resident and the visitor have been vaccinated. The latest data from the Dashboard shows that as of March 20, 55 percent of nursing home residents in Texas were fully vaccinated with one booster dose, a slight increase from mid-February. Among staff, 30 percent are fully vaccinated with a booster dose, a slight increase from mid-February.
Don't Wait Until You Need a Nursing Home to Do Research
Vaccination data points are based on the most current week of data for each facility, as long as it is within the last four weeks. The Dashboard’s use of multiple weeks of data and definition of booster rate and “up to date” rate as a percentage of all residents/staff means that rates may be systematically different than what is reported elsewhere. The uptick in COVID-19 cases in August 2021 prompted AARP to call for requiring COVID-19 vaccinations for nursing home residents and workers. AARP is now calling on nursing homes to require COVID-19 booster shots for residents and staff. Bivalent boosters, designed to protect against the Omicron variants as well as previous strains, have been available since September but utilization has been low. As of mid-November, two and a half months since the shots became available, fewer than half of nursing home residents (45%) and less than one quarter of health care staff (22%) were up to date on COVID-19 vaccinations.
Vaccination data were first reported for the week ending May 30, 2021, and were mandated as of the week ending June 13, 2021. Vaccination data are also available on Care Compare for individual nursing homes, including the percentage of residents and staff up to date. I urge you to include language in the final state budget that ensures nursing home residents receive safe, quality care by enacting provisions to adequately staff nursing homes.
AARP Nursing Home COVID-19 Dashboard
Residents must be able to exercise their rights to visitation, and facilities should be held accountable for ensuring such visits occur. It’s time we require that our nursing home residents are provided with safe environments and high-quality care. The Virginia General Assembly must take action and pass legislation to establish minimum staffing standards to ensure facilities are held accountable for providing that care. For the four-week measures, nursing homes were included only if the facility reported to CDC for all four weeks (nationally, 93% of facilities for the most recent four-week period, for states ranging from 60% to 99%). If a nursing facility reported but had missing data for a specific measure, that facility is excluded from the calculation of that measure for the dashboard. Many states have required self-reporting by nursing homes and/or other long-term care facilities, but the requirements vary widely.
Ensure quality care for residents through adequate staffing, oversight, and access to in-person formal advocates, called long-term care Ombudsmen. Please act now to protect our most vulnerable - include language in the state budget to ensure adequate staffing at nursing homes. Ensuring families and friends can visit their loved ones in nursing homes has been a top priority for AARP, and AARP is advocating for visitation for all to resume as soon as possible, which means that it must be safe. Visitation is key to combatting social isolation which has proven negative impacts on people's health. With new COVID-19 cases in North Carolina long-term care facilities declining rapidly over the past several weeks, facilities that meet criteria have been given the green light to resume indoor visitation while continuing to follow infection prevention recommendations. Data points that go back prior to the first reporting date, including the “since January 2020” counts of resident cases and deaths in the state fact sheets, may significantly undercount the total number of cases and deaths.
Ensure access to in-person visitation following federal and state guidelines for safety and require continued access to virtual visitation for all residents. Prioritize regular and ongoing testing and adequate personal protective equipment for residents and staff—as well as inspectors and any visitors. Require daily reporting of facilities with confirmed cases to help manage the public health response and keep families up-to-date. RALEIGH -- The NC Department of Health and Human Services announced some good news for people who have been waiting patiently, as well as painfully, to visit their loved ones in long-term care facilities. Hold long-term care facilities accountable when they fail to provide adequate care to residents. Improve transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.
In May 2020, the Centers for Medicare & Medicaid Services required nursing homes to self-report COVID-19 cases and deaths on at least a weekly basis; these data are reported directly from nursing homes to the federal government and are consistent across all states. As a result, there is a significant undercounting of cases and deaths before June 2020 in this data source. Ensure adequate staffing and funding levels to meet the needs of long-term care residents and appropriately recruit, train, retain, and compensate care workers.
At the time of that announcement, CMS said it would emphasize education, rather than impose such penalties.
So that they can follow up and the Department can continue to work on measures that will enable safe visitation. And vaccinations through the federal long-term care partnership for COVID-19 vaccinations will continue this month. Beginning in June 2020, the data reported by CMS and by individual states appear to be roughly comparable, though exact comparisons are difficult because of the inconsistency in state reporting. Only 5 states and the District of Columbia have even one third of staff up to date on vaccinations and more than one in ten facilities with 75% of staff up to date.
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