The Morning Call - Your View by Senators Toomey and Casey: How we can reduce nursing homes deaths

Op-Ed

By U.S. Sen. Bob Casey and U.S. Sen. Pat Toomey

Every day, seniors living in nursing homes are dying from the novel coronavirus, or COVID-19, at a rate disproportionate to those living in the community. Countless nursing home aides, nurses, and doctors are risking infection while providing care.

According to the latest reports, more than 20,000 nursing home residents have already died from COVID-19, and workers are scared to return to work. Immediate action is necessary to prevent more people from succumbing to this virus.

First, states and nursing homes should consider adopting the practice of cohorting, which is underway in a handful of states including Pennsylvania. With cohorting, nursing homes can separate residents with COVID-19 and those presumed to have the virus from those who have not been exposed, utilizing separate wings in an existing facility or leveraging nontraditional settings such as hotels and dormitories.

A longer-term strategy will be needed to assist nursing homes in infection control. In the meantime, cohorting has the potential to protect nursing home residents who are not stricken with the virus, while allowing government officials to better target the deployment of personal protective equipment, testing and other essential resources to care for those infected with COVID-19.

The federal government has dedicated significant resources to testing and protective gear and, as a result, we have seen some corresponding improvements in capacity and supply. That said, there are still too few tests available, it takes too much time to receive results and protective gear supply chains remain strained.

While the Centers for Disease Control and Prevention recently revised its COVID-19 testing guidance to give greater priority to people living and working in congregate settings, national, widespread testing is integral to curbing the spread of this deadly virus.

The workers caring for nursing home residents deserve the peace of mind that they will not have to wait up to a week or more before receiving their test results or orders of gowns, masks and gloves while a COVID-19 outbreak strikes their workplace. Adequate testing can inform staffing decisions, and an ample supply of protective gear can ensure the safety of both workers and residents.

With testing and protective gear needs fulfilled, nursing homes will be better prepared to implement effective cohorting strategies.

Improvements should not stop there. Long before this pandemic, we started working together to improve the care provided in a subset of nursing homes that "substantially fail" to meet federally required care standards and resident protections.

Such substandard facilities comprise a little-known federal initiative called the Special Focus Facility program, which was intended to help these nursing homes improve. While more than 400 nursing homes qualify for the program, only 88 receive enhanced oversight and were disclosed to the public.

We are proud of our work to release the list of these previously undisclosed homes for the first time and for securing a commitment from the Centers for Medicare and Medicaid Services to release this list each month moving forward. That said, further improvements to this program are needed to ensure quality improvement for all underperforming nursing homes.

In response to COVID-19, Pennsylvania is providing nursing homes with technical support on infection control practices. Every single nursing home that persistently falls short needs more such consultation, on all parameters of care, and not only in times of crisis.

In the midst of this epidemic, these overdue solutions must be considered alongside a greater emphasis on the availability of testing and protective gear.

The challenge facing our nation's nursing homes, their workforce and their residents and families is unlike any our country has ever seen. Bringing our nation's nursing homes urgently needed resources is now a matter of life and death. We have a responsibility to deliver.

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