On March 17, the U.S. Senate Committee on Finance held a hearing entitled “A National Tragedy: COVID-19 in the Nation’s Nursing Homes.” The hearing focused on how shortfalls have contributed to the severe COVID-19 mortality rate within nursing homes, as approximately 175,000 long-term care residents and staff members have died from COVID-19, representing nearly one-third of all U.S. COVID deaths. Witnesses, who represented a wide array of stakeholders and subject matter experts within the long-term care space, reported that nursing home vaccinations have resulted in an 80 percent decline in COVID-19 cases and deaths among residents and staff, while also emphasizing that more must be done to protect one of the nation’s most vulnerable populations.
Notably, the hearing was held just a week after the Centers for Medicare and Medicaid Services (CMS) relaxed nursing home visitation guidelines to allow for responsible indoor visits, regardless of the vaccination status of the resident or visitor. While the new guidelines recommend that visitors, residents and staff adhere to the core principals of COVID-19 infection control, they provide criteria to facilitate safe, indoor visitation for nursing home residents while also acknowledging the negative impact of separation from family and loved ones has on residents’ physical and mental wellbeing.
Witnesses also testified to the importance of adequate staffing and resources in ensuring long-term facilities provide quality care to their residents. Chronic understaffing of long-term facilities has been exacerbated by the COVID-19 pandemic and, while the American Rescue Plan Act will provide needed funding for nursing home strike teams, they recommended pursuing additional measures to improve staffing levels, such as increased compensation. Witnesses also highlighted how shortages of such critical resources as personal protective equipment (PPE) and COVID-19 testing kits have hampered nursing homes’ ability to properly respond to the pandemic. While shortages have become less severe in recent months, concerns remain over the ability to maintain a reserve supply of these resources.
Witnesses also stressed the importance of oversight and reliable data in ensuring the safety and health of long-term care facility residents and staff. Transparent data allows for accountability within nursing homes, helping to improve the response to the pandemic as well as to identify gaps in the long-term care system. In addition, witnesses spoke to the importance of data in ensuring an equitable pandemic response in nursing homes. According to a recent report, nursing homes serving more than 40 percent non-white residents experienced more than three times as many COVID-19 cases and deaths as those serving primarily white residents. Yet, there have been gaps in COVID-19 data for racial and ethnic minority groups – data which is critical to identifying and addressing disparities in the long-term care system.
Counties play an integral role in helping to ensure the safety of nursing home and skilled nursing facilities’ residents and staff. While COVID-19 vaccinations and recent policy and regulatory changes have significantly improved conditions, ongoing policy and regulatory efforts at the federal level are needed to ensure these facilities have the guidance and resources needed to continue to keep both residents and staff safe long-term.
- NACo Brief: Nursing Homes and COVID-19
- NACo Vaccine Resource Hub
- NACo County Responses to the COVID-19 Pandemic: Aging Services