Witnesses at congressional hearing report “grim conditions” in nursing homes during Covid-19

Nursing homes have become a flashpoint for elderly care during the Covid-19 pandemic, and while some of the problems have been caused by the virus, others reflect long-standing problems and a lack of regulatory oversight, industry officials told congressmen this week.

Nursing home workers, political experts and loved ones of the deceased were among those who testified before the select subcommittee on the coronavirus crisis, which was holding a hearing on Wednesday.

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

Grabowski shared research with the committee and concluded that Covid-19 outbreaks occur in nursing homes were largely a function of where in the country a nursing home is located versus other characteristics of the facility.

“This does not mean that nothing could have been done to prevent Covid outbreaks,” Grabowski said. “Rather, it suggests that policymakers needed to take a systems-level approach to address this issue,” Grabowski said.

Adelina Ramos, a certified nursing assistant at a Rhode Island nursing home, described conditions at the nursing home in spring 2020. She told the committee that while working with residents who could not eat, drink, get out of bed or use the toilet unaided and had to change oxygen every 15 minutes. She had to make “impossible decisions about which residents to help” because the facility was understaffed.

Ramos is now a member of a nurses’ union, which she attributes to improved working conditions like paid sick leave and better health insurance. But she said it was up to the government to look at this struggling industry and take oversight.

“We want policies to ensure we have safe staffing levels more often,” Ramos told the committee.

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

According to witnesses, racism and structural injustice affect both staff and residents of nursing homes dr Jasmine TraversAssistant Professor of Nursing at NYU.

She cited research showing that halls with black residents have significantly more Covid infections and deaths than houses without black residents. This was an issue highlighted during the pandemic, but not caused by it.

“Beyond the pandemic, Black or Hispanic residents are more likely to develop pressure ulcers and receive treatment for pain, prescribe antipsychotics, use restraints, and receive less preventive care than their white counterparts,” Travers said. Residents who identify as LGBTQ+ and live with dementia often don’t receive the care they need, Travers said, because staff have limited knowledge and training and don’t hire staff who are “culturally congruent” for the residents.

She recalled the pungent odors “stinging her nose” when visiting nursing homes during the pandemic because the Centers for Medicare and Medicaid Services waived inspection requirements.

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

Several witnesses criticized former New York Gov. Andrew Cuomo’s failure to address the nursing home crisis, saying he was busy with a book business. a committee member, representative Steve ScaliseR-Louisiana, asked the witnesses for statistics on whether nursing homes in New York were pressured not to follow CDC guidelines after hearing many reports of Cuomo’s failure to reach out to nursing homes in the state during his tenure.

Although none of the witnesses had statistics to hand on how the governor’s orders directly affected nursing homes, one New Yorker described how the virus affected his family.

Daniel Arbeeny, a Brooklyn resident, said four members of his family died from Covid-19 in a week in April 2020, including his father, uncle and two cousins. Three were in nursing homes. Arbeeny cited guidance he received from the nursing home his father was in that he had to take his father home, where it was safer than the nursing home. He said the nursing home has been ordered by New York City regulators to admit Covid-19 positive residents back into their facility, even if they are unequipped.

“It was like a hurricane. There’s no other way to describe how my family got together and made a plan,” Arbeeny said, recalling receiving word 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 died at home of the virus a week later at the age of 88.

Rep. Scalise said he will find answers and statistics on New York regulators’ policies that influenced decisions that affected people like Arbeeny and his family and hold authorities accountable for giving up New York nursing homes.

Based in New York City, the John A. Hartford Foundation is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. The foundation released a statement after the hearing, saying it was “a critical step toward accountability and action to improve American nursing homes.”

Photo: Tempura, Getty Images

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