81,484 in April; 74,299 in December

We never protected residents in facilities from COVID.

Consider the timeline of the pandemic as it relates to residents in long-term facilities:

March 13, 2020: The Centers for Medicare and Medicaid Services announces that nursing home visitors, including family members of residents, are restricted.

April 2020: A total of 81,484 Medicare patients in nursing homes died.

April 30, 2020: President Trump announces the formation of the Coronavirus Commission for Safety and Quality in Nursing Homes to convent in late May. “The commission will comprehensively assess the response,” Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma said. “It will identify best practices, and also provide recommendations for how we go forward to protect our nursing home residents and make sure we are providing the best quality of life.”

September 16, 2020: The Coronavirus Commission for Safety and Quality in Nursing Homes releases its recommendations. “In tasking a contractor to convene this independent Commission comprised of a broad range of experts and stakeholders, President Trump sought to refine our approach still further as we continue to battle the virus in the months to come,” Verma said in a statement. “Its findings represent both an invaluable action plan for the future and a resounding vindication of our overall approach to date. We are grateful for the Commission’s important contribution.”

December 2020: Nursing home patients accounted for 74,299 deaths in December.

June 22, 2021: According to an AP article, a report from the inspector general of the Department of Health and Human Services found that about 4 in 10 Medicare recipients in nursing homes had or likely had COVID-19 in 2020, and that deaths overall jumped by 169,291 from the previous year, before the coronavirus appeared.

The June 2021 inspector general report is damning. Two quotes in that AP article stand out to me:

“We knew this was going to be bad, but I don’t think even those of us who work in this area thought it was going to be this bad,” said Harvard health policy professor David Grabowski, a nationally recognized expert on long-term care, who reviewed the report for The Associated Press. (Grabowski was a member of the Coronavirus Commission for Safety and Quality in Nursing Homes.)

“This is happening long after it was clear that nursing homes were particularly vulnerable,” said Nancy Harrison, a deputy regional inspector general who worked on the report. “We really have to look at that. Why did they remain so vulnerable?” Federal investigators are still drilling down to try to document the chain of causes and effects.

The answer to the question, why did nursing homes remain so vulnerable, is simple. The reason it was so bad is obvious.

No one helped these residents in long-term care settings. Those who wanted desperately to help had to stand outside, some using bucket trucks to see their family member.

When I worked in nursing homes almost 30 years ago, everyone worked when we had a staffing shortage. My job was an admissions director but, when we didn’t have enough staff, I answered call lights and helped residents attend and enjoy activities. I didn’t attend a meeting to talk about what we do now that we know we don’t have enough staff.

When the commission members were announced in the spring of 2020, I read with dismay the congratulatory notes on social media directed to these members. This commission wasn’t about a new achievement for a resume or a Linkedin profile. This commission was formed, from what I read and understood, to save lives. That people died while a commission met with the intent to save lives is horrible.

In the midst of a crisis, let’s not meet. Let’s help. Those commission members, comfortable in their home offices, needed to go into facilities and help. They needed to invite the family members of residents to meet them in facility parking lots, give them PPE and escort them into facilities to help. That we all sat by rather than getting into good trouble haunts me.

Keeping help out killed people. We need to remember that for the next crisis. Next time, we all need to don PPE and go into facilities and help. We need to ignore those “rules” that keep us out. Those rules killed. That data released last week proves that.

We need to help the staff and help the residents. Isolating them and abandoning them to fend for themselves during a horrible, terrible crisis was nothing less than sinful.

(Image by Gerd Altmann from Pixabay.)

Resources

• Please join us on August 17, 18 and 19 at 1 p.m. ET for “Reflections on Caregiving During the Pandemic.” On August 17 and 18, family caregivers will join one-hour panel discussions to share their experiences during the pandemic. On August 19, we’ll convene for an hour to talk out solutions. RSVP.

• Enjoy my podcast with Alzheimer’s Speaks and my video chat with Dementia Careblazers.

• Release the stress that anchors; schedule two free sessions with me to enjoy sunnier summer days.

• Our Beginning Again Retreat will take place on August 6. Join us as you recover from your caree’s death and transition into what’s next. RSVP.

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