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In a puzzling — but perhaps not entirely surprising — display of bad timing, the Trump administration is reportedly thinking about relaxing federal oversight on nursing homes amid a viral pandemic that has already proved particularly dangerous for nursing homes.
According to the New York Times, the proposed plan has been in the works since at least last summer, before the coronavirus began spreading around the world. Since COVID-19 reached the United States, however, nursing homes have been especially vulnerable: The elderly appear more susceptible to the virus than other age groups, accounting for most of the deaths so far, and residents of long-term care facilities may also have the kinds of pre-existing conditions that put them at increased risk of contracting COVID-19. Combine that with close quarters, and the obligation for caregivers to remain in constant contact with their patients, and you can see where infection poses a special problem.
Still, the Trump administration would apparently like to eliminate the Oba-era requirement that nursing homes — which house roughly 2.5 million people nationwide, according to the Times — keep at least one infection-prevention specialist on hand. Under the new plan, those specialists would just have to spend “sufficient time” at facilities, a vague requirement that Anthony Chicotel, a staff lawyer for California Advocates for Nursing Home Reform, described to the Times as “alarming,” because “it adds up to less time, less infection control.”
Seema Verma, administrator for the Centers for Medicare and Medicaid Services, which oversees nursing homes, told the Times that relaxed regulations could lead to a “higher level of staffing” by easing burdens on facilities. But anti-infection specialists serve a vital role, particularly in times like these: They make sure staff stick to crucial safety protocols, like consistently washing their hands. According to Times, CMS reports that about 380,000 residents die from infections annually, and infection prevention is the number-one failure that earns nursing homes federal citations.
Take, for example, the Life Care Center in Kirkland, Washington, where a coronavirus outbreak has already killed 13 residents. Others remain hospitalized, and roughly 60 employees have contracted COVID-19. Within Washington State, almost all of the 31 coronavirus deaths can reportedly be linked to a long-term nursing facility, primarily the Life Care Center. And despite its overall five-star government rating, the Life Care Center has, the Times points out, received citations related to lapses in its infection control program — as recently as 2019. Although the center allegedly corrected its problems, this is precisely the kind of thing you want an anti-infection specialist around to manage.
On Friday, CMS did announce restrictions on nursing home visitors and non-essential personnel, as well as limitations on group activities among residents. But attempting to relax oversight over an industry responsible for caring for the country’s most at-risk population, in the middle of a national emergency? Now really doesn’t feel like the time.
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