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Nursing Homes Brace For Coronavirus Threats


The coronavirus has been especially lethal for older adults. At least five residents at a Life Care Center nursing home in Kirkland, Wash., have died. And many others at the facility, both residents and staff, have shown symptoms of the coronavirus. NPR's Ina Jaffe has this report on the special dangers faced by nursing home residents and staff.

INA JAFFE, BYLINE: After the deaths at Life Care Center in Kirkland, Wash., the federal government is changing its protocol for inspecting nursing facilities. Seema Verma is the administrator of the Centers for Medicare and Medicaid Services, which regulates nursing homes.

SEEMA VERMA: We're going to be refocusing all of our inspectors on infection control, particularly looking at those institutions that have had some concerns in the past or there's been previous violations.

JAFFE: There are 8,200 state inspectors across the country evaluating 15,000 nursing homes, usually on everything from dietary standards to resident rights. But when it comes to infection control, they will have their work cut out for them, says Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy.

TOBY EDELMAN: Infection control deficiencies are one of the top if not the top deficiency cited in facilities.

JAFFE: In fact, according to an analysis from Kaiser Health News, over the past three years, 61% of nursing homes nationwide were cited for deficiencies in infection control. One of those was Life Care Center of Kirkland, Wash., where so many deaths have just occurred, though inspectors later found the problems had been corrected. Nursing home staff and even visitors have a role to play in curtailing infection, says Dr. David Gifford, chief medical officer of the American Health Care Association, the trade organization for most nursing homes.

DAVID GIFFORD: We're asking people who are sick not to visit and employees who are sick not to come into work.

JAFFE: But that may present difficulties for both nursing home staff and their employers. First, according to one study, less than half of nursing home workers received paid time off, which includes both vacation and sick leave. Second, nursing homes have a hard time hiring enough staff to begin with. Turnover is high. If significant numbers of staff have to stay home, there might not be enough workers to care for residents. Randy Bury is president of the Evangelical Lutheran Good Samaritan Society, which operates more than 100 nursing facilities across the country.

RANDY BURY: If one of our sites experiences an outbreak, we, frankly, will deplete the staff in that location.

JAFFE: Bury says that large nursing home chains like his should be allowed to transfer medical personnel across state lines.

BURY: But as soon as you start crossing state lines with medical professionals, you can get into licensing issues.

JAFFE: He's hoping that the federal government will waive those regulations. All this is happening against the backdrop of the Trump administration's proposal to ease many of the regulations that govern nursing homes, including the requirement to have an infection control specialist on staff at least part time. The administration's proposed new rule says that the infection specialist only has to put in, quote, "sufficient time" to control infection. That's despite acknowledging that up to 388,000 nursing home residents die from infections every year. Again, Toby Edelman from the Center for Medicare Advocacy.

EDELMAN: If the Trump administration regulations go into effect, that position becomes a joke. And there will be continued infectious outbreaks in nursing homes that will be very serious, and more people will die who didn't need to die.

JAFFE: But in her conference call, Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, emphasized that reducing the role of the infection control specialist was only a proposed rule and not yet final.

Ina Jaffe, NPR News.

(SOUNDBITE OF MAÑANA'S "FAST DAYS") Transcript provided by NPR, Copyright NPR.

Ina Jaffe is a veteran NPR correspondent covering the aging of America. Her stories on Morning Edition and All Things Considered have focused on older adults' involvement in politics and elections, dating and divorce, work and retirement, fashion and sports, as well as issues affecting long term care and end of life choices. In 2015, she was named one of the nation's top "Influencers in Aging" by PBS publication Next Avenue, which wrote "Jaffe has reinvented reporting on aging."