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The CARES Act relief bill included virtual visitation for federal prisoners, but there were no similar provisions for seniors in nursing homes or other long-term care facilities. The state fact sheets include several measures of the percentage of total state deaths and cases that occurred among nursing home residents and nursing home staff. Because the denominator data is from a different source, the reported data may result in a percentage less than 0% or greater than 100%, which is impossible. The value of each such measure is capped at 100%, and values of less than 0% are marked as NA. These measures should not be used to compute the number of cases or deaths occurring outside of nursing homes.
However we are hearing facilities are slow to open back up and when they do the hours are too limited, making visitation difficult. In the other 44 states, fewer than one third of staff are up to date on vaccines and less than one tenth of facilities have reached the 75% threshold. This weakening of enforcement represents a sharp departure in policy for CMS, which in 2016 issued regulations that included improved protections against abuse, neglect, exploitation and evictions. For example, last November, CMS stopped using for 18 months a number of the enforcement remedies it has to address certain violations, including financial penalties and the termination of eligibility for Medicaid and Medicare funding.
AARP Texas Urges Legislators to Focus on Nursing Home Safety
At the high end, 95% of residents in South Dakota are fully vaccinated, and 70% are up to date. The rate of resident cases in the week ending December 4 is the highest since early February, during last winter’s Omicron surge. Most facilities now meet criteria for in person visitation because there are no outbreaks.
The CDC publishes a Nursing Home COVID-19 Data Dashboard and Nursing Home Vaccination Data Dashboard that are updated weekly and include several key data points at the state and national level. The rate of resident cases is up 63% and the rate of staff cases is up 70% in the week ending December 4, compared to the last week of the dashboard. AARP sent a letter to the Centers for Medicare & Medicaid Services asking officials to strengthen enforcement of quality standards to protect the 1.3 million Americans living in nursing homes.
Protecting Nursing Home Residents from Hurricane Ian
AARP is the nation’s largest nonprofit, nonpartisan organization dedicated to empowering Americans 50 and older to choose how they live as they age. With nearly 38 million members and offices in every state, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, AARP works to strengthen communities and advocate for what matters most to families with a focus on health security, financial stability and personal fulfillment.
Make sure that families get the information they need about their loved ones including knowing their rights when residents are transferred or discharged because of COVID-19. Many Americans think about retirement as the last big plan they’ll ever have to make, but they’ll need to plan to protect themselves against the risk of making poor decisions later in life. In “Make a Plan While You Can,” AARP Bulletin’s personal finance expert offers advice from making decisions on independent or assisted living to designating power of attorney on major medical decisions in case you can’t make them yourself. Men represent 2 out of 5 of the more than 40 million unpaid family caregivers in the U.S., but the role of male caregivers remains hidden. In honor of National Family Caregivers Month, AARP Bulletinreveals why these 16 million men are the best-kept secret of caregivers in America, and why they are breaking stereotypes of the typical caregiver. Also, in this month’s issue, from putting soap in a nylon stocking for a non-slippery soap to using glow tape for safe walks in the house at night, AARP Bulletin offers six clever and low-cost ways caregivers can make everyday tasks easier.
Answers to Your Question About Nursing Homes
AARP is urging the Centers for Medicare & Medicaid Services to strengthen its enforcement of the quality standards put in place to protect the 1.3 million Americans who live in nursing homes. Ensure that facilities are able to provide testing and have the personal protective equipment to keep residents and employees safe. As each day passes, the devastating impact that the pandemic is having on Americans who live and work in nursing homes and other care facilities is becoming more and more clear. According to NCDHHS, case rates are down over 15-fold in skilled nursing facilities, adult care homes and other licensed facilities since the peak of transmission in January 2021.
Vaccination data points are based on the most current week of data for each facility, as long as it is within the last four weeks. The Dashboard’s use of multiple weeks of data and definition of booster rate and “up to date” rate as a percentage of all residents/staff means that rates may be systematically different than what is reported elsewhere. The uptick in COVID-19 cases in August 2021 prompted AARP to call for requiring COVID-19 vaccinations for nursing home residents and workers. AARP is now calling on nursing homes to require COVID-19 booster shots for residents and staff. Bivalent boosters, designed to protect against the Omicron variants as well as previous strains, have been available since September but utilization has been low. As of mid-November, two and a half months since the shots became available, fewer than half of nursing home residents (45%) and less than one quarter of health care staff (22%) were up to date on COVID-19 vaccinations.
Ensure quality care for residents through adequate staffing, oversight, and access to in-person formal advocates, called long-term care Ombudsmen. Please act now to protect our most vulnerable - include language in the state budget to ensure adequate staffing at nursing homes. Ensuring families and friends can visit their loved ones in nursing homes has been a top priority for AARP, and AARP is advocating for visitation for all to resume as soon as possible, which means that it must be safe. Visitation is key to combatting social isolation which has proven negative impacts on people's health. With new COVID-19 cases in North Carolina long-term care facilities declining rapidly over the past several weeks, facilities that meet criteria have been given the green light to resume indoor visitation while continuing to follow infection prevention recommendations. Data points that go back prior to the first reporting date, including the “since January 2020” counts of resident cases and deaths in the state fact sheets, may significantly undercount the total number of cases and deaths.
A survey by AARP of registered voters age 18+ in Virginia showed overwhelming support for a variety of measures to hold nursing homes accountable. More than 7-in-10 (71%) of all voters surveyed support the establishment of minimum hourly staffing thresholds, with support consistent across genders, age groups, and regions. This proposal is supported by almost 8-in-10 (78%) moderate voters and nearly two-thirds (62%) of conservative voters. You must take action to ensure residents receive the care they need by establishing minimum hourly staffing standards. A number of states have taken steps including public reporting of nursing homes and assisted living facilities with COVID-19 cases, increased testing, more PPE, hazard pay for staff, and mobilizing the state National Guard units to support facilities. At the federal level, the Centers for Medicare & Medicaid Services is requiring nursing homes to report confirmed cases of COVID-19 among residents and staff as well as notify residents and families.
Some states combine data for nursing homes and other long-term care facilities such as assisted living; others combine resident and staff cases and deaths, while others provide limited or no data at all. The threat of COVID-19 means nursing home residents generally can’t have in-person visitors. It’s time for full disclosure and immediate action to protect the residents of nursing homes and other long-term care facilities. Help residents stay connected with their families through video chats and phone calls.
Vaccination data were first reported for the week ending May 30, 2021, and were mandated as of the week ending June 13, 2021. Vaccination data are also available on Care Compare for individual nursing homes, including the percentage of residents and staff up to date. I urge you to include language in the final state budget that ensures nursing home residents receive safe, quality care by enacting provisions to adequately staff nursing homes.
In May 2020, the Centers for Medicare & Medicaid Services required nursing homes to self-report COVID-19 cases and deaths on at least a weekly basis; these data are reported directly from nursing homes to the federal government and are consistent across all states. As a result, there is a significant undercounting of cases and deaths before June 2020 in this data source. Ensure adequate staffing and funding levels to meet the needs of long-term care residents and appropriately recruit, train, retain, and compensate care workers.
While high primary vaccination rates for residents and staff have given us hope, and have saved many lives, there remain many nursing home residents who are not vaccinated at all, and more than half are not up to date on COVID-19 boosters. Residents and staff who are not up to date are more susceptible to adverse outcomes from COVID-19 exposure, and staff who are not up to date could place residents at unnecessary risk. Ensuring both residents and staff are up to date with their recommended COVID-19 vaccinations is urgently needed to protect this vulnerable population. “In the year since the pandemic began, we have heard heartbreaking stories about the challenges families have had trying to see their relatives and the many important moments they missed.
Combat often-fatal isolation by connecting residents with their families through virtual visitation. Require nursing home owners to put the majority of taxpayer funding toward direct care for residents—and report this spending. The percentage of facilities in Texas reporting a shortage of nurses or aides decreased slightly to nearly 14 percent in the four weeks ending March 20. Rates of COVID-19 deaths and cases in nursing homes have declined dramatically in Texas and nationwide as the Omicron wave recedes, according to AARP’s Nursing Home COVID-19 Dashboard, covering the four-week period ending March 20.
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