Nursing home understaffing in pandemic harmed residents, House panel says

A special House panel examining the nation’s response to the coronavirus pandemic said it found anecdotal evidence of understaffing in care homes, leading to patient neglect and harm.

At a hearing on Wednesday, the select subcommittee on the coronavirus crisis plans to discuss some of its findings, including how major care home chains are responding to complaints from staff and families.

“Many nursing home facilities were severely understaffed in the early months of the pandemic, resulting in poor care, neglect and adverse health outcomes for residents,” the committee reported Wednesday in a press release ahead of the hearing.

President Biden directed the Centers for Medicare and Medicaid Services earlier this year [CMS] To develop minimum standards for the staffing of nursing homes. By highlighting issues during the pandemic, Wednesday’s House hearing increases pressure on nursing homes and the Biden administration as CMS work continues. The agency recently said it plans to survey staffing levels over the winter.

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The nursing home industry, represented by the powerful American Health Care Association, has said the proposed minimum staffing requirements would cost $10 billion a year. It also said it would need to hire up to 187,000 new staff, which is an “impossible” task amid a severe shortage of healthcare workers across the country. It is said that increased staffing would force a further reduction in bed availability.

However, critics have long cited the understaffing of for-profit nursing home chains as contributing to neglect and poor health outcomes for residents. The House Panel released hotline transcripts of complaints during the Covid crisis on Wednesday. The subcommittee is chaired by Rep. James E. Clyburn (DS.C.).

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“For example, a former resident reported that on April 7, 2020, a Sava facility in Nevada had only one nurse covering two full floors, and that a resident of that facility had thrown up on herself and had not moved for at least two days or showered later while another resident had to wait four hours for water,” the committee reported.

SavaSeniorCare did not immediately respond to a request for comment.

The committee released a compilation of complaints, with all of the complainants’ identifying information removed, filed with three major nursing home chains, SavaSeniorCare, Ensign Group and Consulate Health Care.

The committee also released organizational charts for five companies it studied. Critics have said the muddled structure of nursing home chains — with hundreds of separate companies owning individual facilities and multiple affiliated companies providing services to the homes — has prevented scrutiny of their profits, operations and safety records.

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The American Health Care Association said the subcommittee’s focus on staffing and other issues in the early months of the pandemic predictably painted a picture of nursing homes faltering. Hospitals were prioritized over nursing homes for government support in the early stages, the AHCA said, including personal protective equipment and testing needs.

At the time, “every long-term care provider in the country made a plea for public health officials and policymakers to send help to the front lines and prioritize our nation’s most vulnerable population,” said Mark Parkinson, president and chief executive officer of AHCA. “It is unfortunate that we have to remind lawmakers of what those early days were like.”

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