Nursing home story is sad tale

TOO MANY DEATHS — The nursing home death toll during the coronavirus pandemic has become a sad chapter in the lives of too many older and vulnerable Americans.

Once this coronavirus pandemic comes to an end, a thorough investigation needs to be started to determine why the nation’s long-term care facilities recorded the largest percentage of deaths in this country. Getting the real number of deaths has been extremely difficult.

Louisiana was a hot spot for COVID-19, the coronavirus disease, in its early stages. The Advocate reported that the latest up-to-date data shows the outbreaks in some nursing homes “have been jaw-dropping in scale — with dozens of deaths and infection rates of close to 100 percent — while others have apparently been untouched by the virus…”

Gov. John Bel Edwards said, “COVID-19 concerns me, period, and it especially concerns me when it affects people who are more vulnerable in those congregate settings. Nursing homes check all those boxes.”

The COVID-19 state death toll Wednesday was 2,485 and The Advocate a day earlier reported that 863 deaths (35 percent) occurred in roughly 200 Louisiana nursing homes. Another 65 deaths were reported among residents in 86 other types of residential care facilities.

Susan Hassig, an epidemiologist with the Tulane School of Public Health and Tropical Medicine, said some deaths that were actually caused by COVID-19 may not have been counted. That happened, she said, because a person wasn’t tested before they died or they died outside of the nursing home, perhaps at a hospital.

Testing that didn’t happen early enough has finally gotten the attention of federal and state officials. In Louisiana, state officials have issued guidance that urges nursing homes to regularly test all residents and staff, which should have been done from the beginning.

The Advocate interviewed Katherine Robins, whose husband lives in a Baton Rouge nursing home. Robins has been sounding a nursing home safety alarm for nearly a decade, and here is what the newspaper said about her findings:

“Through a live video feed of his room, she’s watched over the years as one health worker after another … walks past the hand sanitizer on the door, then the one on the sink in the corner, before caring for him.”

Robins said, “They know I have cameras, they know I’m emailing them, and they’re still doing nothing. They don’t even care.”

The nursing home in question has been cited twice for infection-control infractions in the past three years, according to federal inspection records. The latest involved employees not properly cleaning feeding tubes and catheters. Those two infractions were among 21 deficiencies inspectors found in recent visits.

Those deficiencies were serious enough to place residents in “immediate jeopardy.” The federal Centers for Medicare and Medicaid Services gave the nursing home one star on a five-star scale, which equates to “much below average.”

The Advocate said data shows at least 27 of the 41 Louisiana homes with the highest death tolls have been cited for infection control deficiencies within about the past three years. The deadliest death toll in a Louisiana nursing home occurred in St. Landry Parish where 34 residents had died as of Sunday. And 44 of the 51 deaths in St. Landry Parish occurred in four nursing homes.

Medical directors in the state’s nine Department of Health regions are forming strike teams to go into nursing homes and help them administer tests. The Centers for Medicare and Medicaid Services said testing of residents and staff has to happen before nursing homes can begin to loosen restrictions on nursing home residents and visitors.

Those of us with loved ones in nursing homes have been following the sad story of too many deaths for months, wondering how close death might be at any moment. Fortunately, some nursing homes like the one my wife is in have had no COVID-19 deaths, and that is where investigators should start looking to find out how they avoided this nursing home tragedy.

Hassig said early testing, though desirable, would have been impossible in the early days of the pandemic. She said it was hard to get a test anywhere at that time, and that is another important area that investigators should explore.

Testing of nursing home workers should have definitely had a higher priority. Before mask wearing was recommended, federal health guidelines didn’t account for the unknown number of asymptomatic carriers who produce or show no symptoms. They could have unknowingly spread the virus while either developing symptoms days later or none at all.

Nursing home testing is an expensive proposition, according to the American Health Care Association and National Center of Assisted Living. It says regular testing of residents and staff at Louisiana’s 278 nursing facilities would cost nearly $8 million.

Those organizations have asked the U.S. Department of Health and Human Services for $10 billion in emergency relief to help fund the necessary testing. The funds are needed, but even if they come, it’s much too late to help the most vulnerable citizens in America who are no longer with us.

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