Feds should do more to safeguard nursing homes from COVID-19, U. of C. expert tells Senate panel

The federal government should come to the rescue of people in nursing homes that primarily serve non-white residents because those are where the risk is highest of being infected with the coronavirus and dying, a University of Chicago professor testified before a U.S. Senate panel Thursday.

In online video testimony, Tamara Konetzka, who has researched nursing homes for 25 years, told members of the Senate Special Subcommittee on Aging an “emergency influx of resources” is needed for nursing homes, particularly those with the highest risk of having coronavirus outbreaks.

She recommended that nursing homes test all residents at least twice a month.

Konetzka looked at COVID-19 infections in more than 5,500 nursing homes in Illinois and 11 other states and found that nursing homes with the lowest percentage of white residents were more than twice as likely to have a coronavirus case or death.

Nearly half of all coronavirus-related deaths in Illinois have occurred in nursing homes.

In Illinois and other states, African Americans are contracting the disease and dying at a disproportionately high rate in the general population and in nursing homes.

“Nursing homes serving predominantly nonwhite residents are more likely to be located in predominantly nonwhite neighborhoods and to draw staff from those neighborhoods,” Konetzka told senators. “As these are the neighborhoods and the people being most affected by the pandemic, nursing homes in these areas are also most at risk.”

During the hearing, senators from both parties criticized the Trump administration for not providing more information about outbreaks and testing in nursing homes and other longterm-care facilities.

Sen. Susan Collins, R-Maine, who chairs the panel, criticized the Trump administration for not following through on a number of programs Congress has funded to fight coronavirus: free testing, more money for Medicaid and personal protective equipment, additional resources for front-line medical professionals, direct aid to states, support for businesses and their employees, and home-healthcare planning.

“Much of the funding provided through these bills has yet to be released by the Department of Health and Human Services,” Collins said. “I urge the department to act with urgency so that this funding can flow to areas where it is desperately needed.”

Senators also offered condolences to Sen. Elizabeth Warren, D-Massachusetts, whose 86-year-old brother died Tuesday of complications from the disease.

Warren noted that about 800,000 Americans are in assisted-living centers, which aren’t federally regulated like nursing homes. She’s pushing legislation to require assisted-living centers to report COVID-19 cases and deaths.

Nursing homes already must provide that information to the U.S. Centers for Disease Control and Prevention.

Konetzka told the senators such information allows federal and state governments to focus help on the neediest facilities and gives families more information about the places their loved ones are living in.

Sen. Richard Blumenthal, D-Connecticut, said he’s supporting a bill to require weekly tests and have a full-time infection control expert in every nursing home.

Blumenthal also said it’s important that nursing homes have the technology to arrange virtual visits between residents and families.

Sen. Kirsten Gillibrand, D-New York, wants to create a federal “health force” of 1 million workers to administer tests and eventually vaccinations, which Konetzka also supported.

Konetzka agreed with senators that nursing homes and other longterm-care facilities are facing severe shortages of masks and gloves.

Staffing shortages also are a problem, Konetzka testified. That was true even before the pandemic, she said, and the problem has grown worse because some nurses and aides are worried about getting the disease and haven’t shown up at work.

Benefits for most nursing-home workers don’t include paid sick leave, guaranteed health insurance or hazardous-duty pay, Konetzka said. Those benefits would help retain and recruit staff members, she said.

Some committee members said they would support a law providing those benefits.

The government also could provide nursing-home workers with free hotel rooms if they are worried about jeopardizing their families’ health, Konetzka said. Chicago has done that for hospital workers.

Konetzka also recommended the federal government:

• Form “surge teams” to provide the neediest nursing homes with extra staff and technical expertise.
• Provide those facilities with sanitation training. Nearly two of five nursing homes nationwide were cited with inadequate infection control in 2017, she noted.
• Lift the limit on the number of families who can have their loved ones receive caregiving services at home through Medicare.

Konetzka testified she and U. of C. graduate student Rebecca Gorges compared Medicare quality ratings for nursing homes with coronavirus cases and didn’t find a strong correlation statewide in any of 12 states they studied.

They did find a link in Cook County, where the worst-rated nursing homes have had the highest number of COVID-19 cases and deaths. A Chicago Sun-Times examination published earlier this month documented that pattern.