Witnesses tell of 'dire conditions' in nursing homes during Covid-19 at congressional hearing - MedCity News

Nursing homes have become a critical point of care for the elderly during the Covid-19 pandemic, and while some of the problems were caused by the virus, others reflect long-standing problems and a lack of regulatory oversight, industry stakeholders told members of Congress this week .

Nursing home workers, policy experts and relatives of the dead were among those who testified before the select subcommittee on the coronavirus crisis, which held a hearing on Wednesday.

Dr. David Grabowski, a professor of health policy at Harvard Medical School, described the “horrendous conditions” in nursing homes in 2020. The pandemic has “lifted the curtain on nursing home care in America,” he said.

Grabowski shared research with the committee concluding that outbreaks of Covid-19 are breaking out in nursing homes were largely a function of where in the country the nursing home was located compared to other specifics of the facility.

“This is not to suggest that nothing could have been done to prevent Covid outbreaks,” Grabowski said. “Rather, it suggests that policymakers should have taken a systems-level approach to dealing with this problem,” Grabowski said.

Adelina Ramos, a certified nursing assistant at a nursing home in Rhode Island, described conditions at the nursing home in the spring of 2020. She told the committee that while working with residents who unable to eat, drink, get out of bed or go to the toilet unaided and requiring oxygen to be changed every 15 minutes, she had to “make impossible choices about which residents to help” as the facility was understaffed.

Ramos is now a member of a nurses union, which she credits for improved working conditions, including paid sick leave and better health insurance. But she said the government needed to look at this struggling industry and provide oversight.

“We want guidance to ensure that we have safe staffing levels more often than not,” Ramos told the committee.

“The majority of nursing home workers are women and people of color, and we are often called unskilled and uneducated,” Ramos said. “Our jobs are devalued and it’s disgraceful that after two and a half years of a daily pandemic we’re still being treated this way and we’re fed up with the lack of respect from nursing home owners and lawmakers so our workforce is needs change to happen now.ā€

Racism and structural inequalities affect nursing home staff and residents alike, witness says Dr Jasmine Traversassistant professor of nursing at New York University.

She cited research showing that halls with black residents experience significantly more Covid infections and deaths than homes without black residents. It was a problem highlighted during the pandemic, but not created by it.

“Beyond the pandemic, compared to their white counterparts, black or Hispanic residents are more likely to develop pressure ulcers and be treated for pain, prescribed antipsychotics, placed on restrictions, and less likely to receive preventive care.” , Travers said. Residents who identify as LGBTQ+ and living with dementia often do not receive the care they need, Travers said, due to limited staff knowledge, training and a failure to hire staff who are “culturally congruent” with residents.

She recalled pungent odors “stabbing” her nose when she visited nursing homes during the pandemic, as the Centers for Medicare and Medicaid Services waived inspection requirements.

“I urge the subcommittee to recognize that older people do not want to stop living, even though they may need help to live,” Travers said.

Several witnesses criticized former New York Gov. Andrew Cuomo’s failure to address the nursing home crisis, saying he was preoccupied with a book deal. One committee member, Representative Steve ScaliseR-Louisiana, asked witnesses for statistics on whether New York nursing homes were pressured to not follow CDC guidelines after hearing many accounts of Cuomo’s failure to address the state’s nursing homes while in office.

While none of the witnesses had statistics on the direct impact of the governor’s orders on nursing homes, one New Yorker described how the virus has affected his family.

Brooklyn resident Daniel Arbini said that in one week in April 2020, four of his family members died of Covid-19, including his father, uncle and two cousins. Three were in nursing homes. Arbini cited instructions he received from the nursing home where his father was, saying he should bring his father home where it would be safer than in a nursing home. He said the nursing home has been instructed by New York City regulators to readmit positive Covid-19 residents to their facility even if they are not equipped.

ā€œIt was like a hurricane. I have no other way to describe how my family came together and made a plan,ā€ Arbini said, recalling when he got the news from the nursing home that his father would be safer at home. “We were in a race for our lives and we knew it,” although his father eventually died at 88 from the virus while at home a week later.

Rep. Scalise said he would seek answers and statistics about New York regulatory directives that affected decisions affecting people like Arbini and his family, and hold accountable the authorities who abandoned New York’s nursing homes .

The John A. Hartford Foundation, based in New York, is a private, nonpartisan, national philanthropy dedicated to improving care for the elderly. The foundation released a statement after the hearing saying it was ā€œa critical step toward accountability and action to improve America’s nursing homes.

Photo: Tempura, Getty Images

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