Army nurses test a resident of a nursing home in New Jersey. US Army photo by Spc. Miguel Pena.

The COVID-19 pandemic has hit nursing homes especially hard. The AP says nursing homes account for "about a third" of deaths; the New York Times says it's "over a third"; and ABC News suggests the number is more like 31 percent nationwide, but also pointing out that 15 states don't report deaths in nursing homes as part of their coronavirus stats at all. So for the 35 states and DC that do report nursing home deaths, that works out to 40 percent.

Hey, why aren't we giving you statistics from the federal government? That's because the Centers for Medicare and Medicaid Services (CMS), which oversees federal regulation of nursing homes, didn't start requiring nursing homes to report coronavirus infections and deaths directly to the CDC until late April, and won't get around to releasing any data until the end of May. Oh, yes, and on April 30, two months into the outbreak, and long after everyone knew the disease was spreading out of control in nursing homes, the White House finally created a national task force on coronavirus in long-term care facilities. That was not quite two weeks ago, so hooray for the quick action.

So with all the horror going on, it only stands to reason that CMS, part of the Department of Health and Human Services, is circulating a draft of a plan to "reopen" nursing homes so people can go visit Nana as soon as possible. Yes really, although the Wall Street Journal dutifully notes that the "final version of the guidelines might be significantly different from the early draft" that its reporters obtained. Like if people all stand up and scream "ARE YOU FUCKING INSANE?"


For a good, horrifying look at how bad the situation in nursing homes has been, check out this heartbreaking New York Times story on the situation at the New Jersey Veterans Home at Paramus, where as of Tuesday, 74 deaths had resulted from COVID-19. That's out of a late-March population of 314 residents.

The list of the dead is almost certain to grow: Of the remaining 209 veterans and their spouses, 133 had either tested positive for the virus or were awaiting results. About one in five staff members has contracted the virus, and one employee has died.

"The whole place is sick now," said Mitchell Haber, whose 91-year-old father, Arnold, an Army veteran, died last month at the home, which is about 12 miles northwest of New York City.

"What they should really do is raze it and put a park there,'' he said. "It's like a mass shooting."

All told, New Jersey nursing facilities have seen 4,953 fatalities, which make up over half of COVID-19 deaths in the state. Jesus. The state attorney general is investigating facilities that have had high numbers of deaths, with the possibility that there may be criminal charges if negligence is found.

But as we said in the headline up there, this could all be even worse, since before the pandemic got under way, the Trump administration was working to loosen infection control standards in nursing homes. In response to the deaths of hundreds of nursing home residents in Hurricane Katrina, and thousands of people stranded in nursing homes following Hurricane Sandy, both George W. Bush and Barack Obama enacted stronger safety standards for long-term care facilities. Obama's administration tightened up infection control standards in 2016, putting in place more protections for residents and higher fines for violations. Those rules were targeted by the nursing home industry once Trump took office, and by golly, CMS was happy to help make nursing homes more profitable by cutting burdensome regulations.

In particular, the rules on infection control were targeted. In 2019, CMS drafted a revision that would get rid of the Obama requirement that every nursing home

employ at least one specialist in preventing infections. The proposed rules — which the agency is completing and has the power to enact — eliminate the requirement to have even a part-time infection specialist on staff. Instead, the Trump administration would require that anti-infection specialists spend "sufficient time at the facility."

Critics say the proposed requirement is so vague that it would be essentially meaningless — and dangerous.

"It adds up to less time, less infection control," said Anthony Chicotel, a staff lawyer for California Advocates for Nursing Home Reform. He said the proposed change was "alarming."

In March, even after COVID-19 had killed 45 residents of a nursing home in Kirkland, Washington, CMS Administrator Seema Verma insisted that the proposed deregulation wasn't about letting nursing homes slack off, but rather about making sure the government isn't "micromanaging" how facilities control infections. Yeah, that's it! Flexibility. And avoiding "burdensome" regulations. Who knows, she told the New York Times, the changes might even bring about a "higher level of staffing." Which is true, we suppose, if you took the salary for a qualified infection control person, used it to hire a drive-by consultant and a person at minimum wage. Why, you might even be able to squeeze a little "juice"! Of course, that's just us speculating.

While the effort to undo those Obama-era safety rules hasn't actually gone forward during the pandemic, there's no reason to think the administration won't still try to jam it through. And Republicans are pushing for any new stimmy bill to include broad immunity from liability, not only for businesses, but for hospitals, which may or may not include nursing homes depending on how any legislation is written. And just to be on the safe side, the for-profit nursing home industry is lobbying for states to provide immunity from lawsuits for nursing homes, their owners, and employees, too.

As NBC News explains, such immunity provisions wouldn't necessarily exempt nursing homes from all liability, or at least executives in the nursing home industry say it wouldn't. Residents or their families could still sue for extreme neglect, and isn't that good enough?

"We are responding to a disaster," said Charles Downs, corporate counsel for Virginia Lutheran Homes. [...] He says the industry's request for immunity would apply only to the lower bar of what is known as "general negligence" and would not rule out lawsuits for cases of "gross negligence" or extreme neglect.

Well gosh, isn't THAT nice!

Now, to be sure, the Trump administration has — very grudgingly and half-assedly — finally noticed there's a problem in nursing homes. There's the new task force, which is claiming it will get two weeks' worth of protective equipment to all nursing homes (possibly if Jared can make some fall off a truck).

And on Monday, Mike Pence announced during a conference call with governors that the government was "recommending" that all nursing home residents in the US be tested, although it wasn't an actual order, and it also didn't come with any plan to provide tests, funding, or staff to make that possible. And Deborah Birx backed Pence up, too, saying "We really believe that all 1 million nursing home residents need to be tested within next two weeks as well as the staff" — though she didn't offer any equipment or funding either.

At least Donald Trump took a firm stand on testing nursing home residents: He blamed the states.

President Trump has repeatedly said there have been plenty of testing kits and has shifted blame to governors for reacting too slowly on testing, a charge he repeated in a Rose Garden news conference later Monday.

"Frankly, some of the governors were very lax with respect to nursing homes. It was obvious right from the beginning," Trump said, referring to the Washington state outbreak.

Trump also promised even more decisive action, kind of, at least if you actually believe "words coming from his mouth," which would make you a damned fool:

Asked why testing was recommended, not ordered, Trump said: "I would certainly consider that. I will mandate it if you'd like."

But he said that at some point before he lost his shit and stormed off, so if he forgets his "promise," you'll have to blame the lady reporters who ask him such nasty questions.

We probably wouldn't have given you very good odds if you had predicted at the beginning of 2020 that this would be the year many on the American Right would decide euthanasia was OK with them, as long as they can still ban abortion. But a crisis does tend to bring out people's true colors, so now we're treated to the likes of Bill O'Reilly explaining that a lot of the people who've died from COVID-19 "were on their last legs anyway." And in the case of America's nursing homes, the Trump administration seems to be doing all it can to reduce the number of retirees living the high life on Social Security and Medicare. But will anyone thank him for such bold action to save money? Probably not. They're so nasty.

[NYT / WVEC-TV / AP / McKnight's / WSJ / NYT / NBC News / US Army photo by Spc. Miguel Pena]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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