HARRISBURG – Many of the same issues that plagued the Wolf Administration’s management of long-term care facilities at the outset of COVID-19 still remain a problem four months into the pandemic, according to testifiers at a Senate Aging and Youth Committee hearing on Thursday.
An initial hearing on the issue on May 7 exposed numerous shortcomings in the Wolf Administration’s approach to protecting residents and staff during the pandemic. Committee Chair Senator Judy Ward (R-30) raised additional concerns about the continued isolation of residents, many of whom have not been able to see their families for nearly four months.
“Many of us have specific examples of how this has affected families and their loved ones in long-term facilities,” Ward said. “I have had several individuals reach out to me about not being able to see their loved ones. One woman cried because her mother has dementia and might not remember her. A Senate staffer lost a parent in a long-term facility and was not able to see them to say goodbye.”
Ward noted that her own mother is a resident at a nursing home.
“I know I am speaking for so many out there going through the same thing. This hearing is extremely important to many Pennsylvanians and to me personally as we look at where we stand in regards to testing, protective equipment and instituting safe plans to start to open these facilities,” Ward said.
Carol McKinley, President & CEO of Simpson Senior Services, detailed some of the measures they have implemented to keep residents connected with loved ones, including “drive-in” visitation in which family and friends remain in their cars while residents sit outside.
She and other testifiers outlined plans to implement cautious visitation policies and safe group activities when these activities are permitted by the state. State guidance prohibits facilities from reopening to in-person visitation until at least 28 days after the county moves to the Wolf Administration’s green phase of reopening.
David Nace, Chief of Medical Affairs for the University of Pittsburgh Medical Center’s (UPMC) Senior Communities, noted that early intervention, enhanced screening and other precautions led to just two residents of UPMC’s 36 facilities testing positive for COVID-19.
“Universal testing – occurring across the Commonwealth – provides us with important information on the prevalence of COVID-19 among our residents and staff,” Nace said. “However, we cannot test our way out of this crisis. To move forward, we must take a bundled approach that incorporates meticulous execution of basic infection control processes.”
Additional testimony focused on the ongoing lack of access to proper testing and equipment. Ward noted that while hospitals were prioritized for personal protective equipment (PPE) at the outset of the pandemic, updated guidance on distribution of PPE that made congregate care settings a priority was not issued until April 27.
Secretary of Health Rachel Levine testified that she believes adequate testing will be available to meet the goal of universal testing of residents and staff by the Department of Health’s July 24 deadline.
However, despite lawmakers directing $692 million in new federal funding to long-term service providers, many facilities still do not have access to an adequate number of COVID-19 testing kits to meet the state’s universal testing requirements, said Adam Marles, President and CEO of LeadingAge PA, which represents 360 nonprofit providers of senior housing, health care and community services in Pennsylvania.
A partnership between the Department of Health and CVS promises 50,000 tests, but this falls well short of the needs of Pennsylvania’s 80,000 residents and 100,000 staff of long-term care facilities.
“It’s somewhat reminiscent of the golden ticket from Willy Wonka’s wondrous chocolate factory,” Marles said. “That is, it’s good for marketing, but it leaves the majority disappointed with the outcome.”
Pennsylvania Health Care Association President & CEO Zach Shamberg also expressed frustrations about the inability of providers to access necessary supplies throughout the pandemic and the spike in costs for PPE, as well as delays in testing. He noted that other neighboring states have already implemented universal testing on a recurring basis and have lifted some of the most onerous visitation restrictions.
“To put it very simply, what happened in March, and April, and May, and June can never happen again. Pennsylvania’s long-term care sector will simply not survive,” Shamberg said. “Testing remains an issue for providers, and it is because of conflicting guidance.”
Concerns were also shared about errors in data shared with the public by the Department of Health. Although Secretary Levine attributed data errors to incorrect information submitted from providers, Marles testified that numerous instances have been documented in which the Department of Health repeatedly distributed incorrect data despite proper reporting by facilities.
Garvey Manor Nursing Home Administrator Sister Joachim Anne Ferenchak also echoed the concerns about data reporting requirements for the CDC and the Department of Health, noting that numerous reports including the same information are required on a regular basis. A letter from Secretary Levine to providers last week threatened daily fines of up to $300 and up to 30 days of incarceration for reporting by facilities that did not adhere to the Department’s standards.
“While the need for data collection is recognized and respected, the duplicity of reporting is burdensome and unnecessary,” Ferenchak said. “The data provided in our reports is important, we know, but repeating it three times is not warranted in this day and age when data sharing is so easily accomplished. It would be a relief of a burden on already stressed nursing homes and long-term care administrators if the Department of Health would be supportive in lessening this demand and working with us in a more collaborative manner to receive the data that they request.”
Several testifiers also urged the Senate to consider legislation to protect nursing homes and long-term care facilities from lawsuits resulting from state mandates to admit COVID-19 patients.
“The nursing home industry is presently a prime target for personal injury suits related to the initial poor guidance and lack of personal protective equipment provided as well as the inability of many nursing homes to have the physical structures to appropriately quarantine patients they were mandated to admit,” said long-term care consultant Michael Grove. “Personal injury law firms have already begun ads on Facebook encouraging families to contact them regarding concerns they have as it relates to the care of their loved ones in nursing homes.”
Senators also raised questions about the Department of Health’s guidance requiring long-term care facilities to admit patients who tested positive for COVID-19 after they are discharged by hospitals. Jamie Buchenauer, Deputy Secretary for the Office of Long-Term Living in the Department of Human Services, testified that they are exploring options to provide an extra stop between hospital discharges and readmission to long-term care facilities.
Video and testimony from the hearing will be available at https://www.pasenategop.com/blog/062520/.
CONTACT: Cheryl Schriner (717) 787-5490