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Monday, April 27, 2020

Why Nursing Homes Are Being Overrun By The Trump Pandemic

You guessed it: gutted Obama-era regulations and an industry crony who has Trump’s ear
By Sarah Okeson

Coronavirus cases surge at nursing homes as workers battle 'almost ...Former Kansas Gov. Mark Parkinson, a Democrat but the CEO of a nursing home industry group, wrote Trump after the 2016 election seeking a “collaborative approach” to regulation, much like the one the Federal Aviation Administration has had with the aircraft industry.

Team Trump acquiesced, rolling back fines and proposing to weaken rules for infection prevention employees. That collaborative approach has failed, much as it did with the FAA , the agency that enabled failures in the design of the Boeing 737 Max.

Shoddy federal oversight of planes helped kill 346 people. The death toll from the pandemic, where health officials Seema Verma and Alex Azar helped turn our nation’s nursing homes into Trump death traps, is more than 46,000.

So far, more than 7,000 residents or people connected to nursing homes have died. That number includes 12 residents at the Milford Center in Delaware owned by Genesis HealthCare which has an executive, Michael Wylie, who previously chaired the American Health Care Association board.

Parkinson was paid about $3.3 million in 2017 by the association which represents more than 14,000 nursing homes. The association had 45 lobbyists in 2019, including Brian Ballard, the former chairman of Trump’s fundraising committee.

Especially Vulnerable

Nursing home residents are especially vulnerable to infections spread among groups such as the flu and norovirus.  In a normal year, almost 388,000 of our nation’s elderly and disabled die of infections they got in nursing homes.

Under Obama, the Centers for Medicare and Medicaid Services created a new position for nursing homes to try to help prevent infections from spreading. The employees, infection preventionists, are supposed to make sure nursing home staff properly clean their hands, disinfect surfaces and other measures to prevent illnesses in residents and staff.

The requirement was part of a 2016 rule that was the first major update to requirements for long-term care providers since 1991. The rule also included protections against abuse, neglect and exploitation of Medicare and Medicaid beneficiaries.

In 2016, a fifth of skilled nursing facilities were cited for actual harm or jeopardy to residents. Only 6.5% had no deficiencies in 2016.

Fines Drop

Under Trump, fines for nursing homes that injured or endangered residents dropped to an average of $28,405 compared with $41,260 during the last year of Obama’s administration. In 2017, CMS put an 18-month moratorium on fines and other penalties for some of the tougher regulations, saying it would use the time to “educate surveyors and the providers.”

Now, Verma and Azar want to weaken the infection preventionist position, changing the position from at least part-time to spending “sufficient time” at the facility. Nursing home inspectors started focusing exclusively on infection control after the pandemic started.

Knock ‘Em Out

More than 1,500 people or organizations commented on the proposed changes, many of them from the nursing home industry. The cutbacks, which also include weakening a resident’s right to file a grievance and allowing nursing homes to medicate residents with antipsychotic drugs indefinitely, are expected to save nursing home operators more than $600 million a year.

Some of the nursing home executives who asked federal regulators to weaken the standards for infection preventionists have had COVID-19 outbreaks in their facilities.

Deb Fournier, the chief operations officer for Maine Veterans’ Homes, said in September that she supported the proposed Trump changes in employees charged with preventing infections.

“This will allow LTC facilities to use workforce resources in a manner that best meets the needs of their organizations,” she wrote.

Two people have died at the veterans’ home in Scarborough, Maine, and 38 people have gotten sick.