To the Editor:
Re “Federal Response to Covid in Nursing Homes” (letter, Sept. 12):
I am unable to accept the revisionist response from Seema Verma, administrator of the Centers for Medicare & Medicaid Services, to your Sept. 6 editorial criticizing the government for the high number of nursing home deaths.
Contrary to her assertion of “early, rapid action,” we found the response here in Lancaster County to be glacially slow and dangerously inefficient. Rather than a federally coordinated response to the pandemic, we were left to design our own response, in particular to the acquisition and distribution of personal protective equipment.
Early on during the pandemic, it became painfully apparent that within our community first responders and nursing home facilities were dangerously unprepared and ill equipped. Nursing home residents were being cared for without the most basic protection for health care providers, such as face masks. In response, a physician friend of mine and I organized a program to acquire and distribute P.P.E.
Tragically, dangerous inefficiencies persist in the federal response, particularly regarding mass testing. We remain dependent upon the stuttering governmental response as the pandemic continues to wreck our health and economy.
Roy Small
Lancaster, Pa.
The writer is a cardiologist.
To the Editor:
“The Shameful Toll of Nursing Homes” (editorial, Sept. 6) fails to address an additional crisis facing our nursing homes: deaths precipitated by isolation.
My mother is a resident in a New York State nursing home. I have not been able to visit her since March. Her decline these past six months tells an all-too-familiar tale of seniors left isolated in their rooms, with family unable to provide support, care and companionship.
Despite the efforts of dedicated staff, she has lost over 22 pounds, and her dementia has dramatically worsened. She exhibits what’s called a “failure to thrive.” In fact, rigid safety regulations have created barriers to safe family visits. This, in turn, has contributed to her rapid decline.
It doesn’t have to be this way. To allow for safe visits, family members should be subject to the same safety protocols as staff.
My mother is now in hospice care, and I’m told she has just weeks to live. I’m still unable to visit her, take her hand and tell her I love her. When the nursing home staff determines she is within a 72-hour window of death, I’m allowed an end-of-life visit. Certainly, we can do better than this.
Lisa Rose
Radnor, Pa.
The writer’s mother died shortly after this letter was submitted. She never got a final visit.
To the Editor:
Your editorial is far-ranging in its critique of the nursing home industry and the Trump administration for the number of Covid-19 deaths in nursing homes, though I wish it had focused on the lack of any comprehensive national policy on long-term care as an underlying cause of the problems.
In commenting on the Justice Department’s investigation into certain states (notably, only states with Democratic governors) that allowed transfers of patients from hospitals to nursing homes, you say these transfers “were almost certainly unwise.” Our research in Michigan and other states disputes this statement.
Our analysis shows that Covid-19 patients not in need of hospital care can be safely transferred to nursing homes with the right safety protocols in place. The emphasis needs to be on ensuring adequate training, P.P.E., staffing and a specialized Covid-19 unit, not on ending the practice.
Marianne Udow-Phillips
Ann Arbor, Mich.
The writer is director of the Center for Health and Research Transformation at the University of Michigan.
To the Editor:
As the editorial noted, nursing homes and assisted living communities did not receive the assistance needed early in the pandemic. Though nursing homes care for one of the most vulnerable populations, the focus remained on hospitals. Lack of access to personal protective equipment and testing was a serious challenge.
However, it’s notable that independent research shows little correlation between outbreaks and quality ranking, ownership structure or staffing levels; instead, outbreaks are tied to spread of the virus in communities.
Longstanding staffing shortages and low Medicaid reimbursement rates have been compounded by the pandemic. Significant Covid-related costs have left many facilities on the brink of closure.
This is a historic challenge, one we must continue to confront together. Many of the issues the editorial identified have been the focus of long-term care providers for years. We hope Congress will now work with us to address them.
Mark Parkinson
Washington
The writer is the president and chief executive of American Health Care Association and National Center for Assisted Living.
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