Rage Builds As Feds Slow-Walk COVID Nursing Home Cash

Weeks into the national lockdown, the Canterbury Rehabilitation and Healthcare Center outside Richmond had become the site of one of the nation’s worst localized outbreaks of COVID-19, with 45 residents dead of COVID-19 in a little over a month.

“A publicly funded nursing home is a virus’ dream,” Dr. Jim Wright, the chief medical officer at Canterbury, said at the time. “People are close together, their immune systems are compromised—it is just a tinder box for that match.”

By April 13, Rep. Abigail Spanberger (D-VA), who represents the area, was on MSNBC explaining what nursing homes like Canterbury needed—namely, a whole lot of federal relief money, and fast, so that facilities could stock up on COVID-19 tests to help identify outbreaks, personal protective equipment for caregivers, and funds to hire additional staff as existing ones fell ill or left.

But by May, the needed relief had still not arrived and the Department of Health and Human Services has not still not clearly explained to Spanberger and her colleagues why the billions of dollars set aside for nursing home relief in the CARES Act, the $2.2 trillion COVID-19 response legislation that passed on March 27, was not immediately distributed. 

It was only last week that HHS announced it was beginning to direct $4.9 billion in relief toward the country’s nursing homes—a sum that lawmakers like her believe amounts barely to a down payment in addressing urgent problems, like providing the level of testing that’s needed and securing adequate PPE and staffing.

“It’s tremendous, the gap between $4.9 billion spread across eligible facilities and the actual need,” Spanberger told The Daily Beast. “These are not limitless funds, but many people agree that $4.9 billion is far less than it should be.” 

A bipartisan group of members of Congress have urged HHS to make at least $25 billion—out of the $175 billion health-care fund set up in COVID legislation—available to a broad range of nursing homes and long-term care facilities. So far, Spanberger said that she’s not received any indication of when HHS might move on releasing more money for nursing homes, among other things, and described her communication with the agency as “a little bit like a one-sided pen pal relationship.”

In the meantime, death tolls continue to mount at nursing homes around the country, with 42 percent of all COVID-19 deaths in the U.S.—over 40,000—coming from facilities that care for the elderly. The industry itself is struggling, and smaller operators could face insolvency in the near future unless they get relief from the government, according to experts in the field.

Though the coronavirus outbreak has overstretched a federal government now forced to confront an untold number of new, life-threatening emergencies, some lawmakers and advocates have been baffled at the slow pace of the administration’s response to COVID-19’s uniquely lethal impact on nursing homes. The first major U.S. outbreak of the disease, in February, was at a nursing home in Washington state—an early sign that the illness could spread rapidly in facilities crowded with the elderly.

That essential funding for those facilities would take such a long time to get out the door, say some experts, is tantamount to a failure of leadership from the Trump administration. “The administration has had no clue what it’s doing in regard to older adults and long-term care,” says Michael Wasserman, director of nursing home patient safety for the California Association of Long-Term Care Medicine, a professional group for health care providers.

Though there are “really good people” working at agencies like the Centers for Disease Control and Prevention, Wasserman says the onus falls squarely on leadership at those agencies and at the White House. “I’m worried the administration is just completely blind to what’s going on in nursing homes and has not been focused whatsoever on effectively dealing with it.”

Publicly, officials from the administration have acknowledged the need to direct funding from the CARES Act to nursing homes as outbreaks in those facilities worsened over the month of April. On April 22, HHS Secretary Alex Azar said “there are still some providers” who need special help. “Skilled nursing facilities, for instance, need funds both as part of our general provider compensation efforts and because they are suffering particular costs from COVID-19,” he said.

A month later, on May 22, Azar announced the release of $4.9 billion to nursing facilities. “This funding secured by President Trump will help nursing homes keep the seniors they care for safe during the COVID-19 pandemic,” said Azar. “The Trump Administration is providing every resource we can, from funding and direct PPE shipments to regulatory flexibility and infection control consultations, to protect seniors in nursing homes and those who care for them.”

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