Nursing home leader warns of death and devastation

Nursing home leader warns of death and devastation

Asks state for more testing, more PPE, and $130m more a month

April 13, 2020

THE PRESIDENT of the Massachusetts Senior Care Association on Monday warned of death and devastation at nursing homes unless the state dramatically ramps up COVID-19 testing of residents and employees, prioritizes the delivery of personal protective equipment, and funnels an additional $130 million a month to the industry.

In a letter to Gov. Charlie Baker, House Speaker Robert DeLeo, and Senate President Karen Spilka, Tara Gregorio said modeling indicates one-third of nursing home residents are likely to become infected during the COVID-19 outbreak and 3 percent, about 1,140 people, are likely to die. Under a worst-case scenario, she said, half of all residents would become infected and 10 percent, or 3,800 people, will die.

“Given the vulnerability of the nursing facility population, this devastation will continue to increase at alarming rates without immediate and urgent action on the part of state government,” Gregorio wrote. “Specifically, we need any and all additional resources to immediately staff our nursing facilities, test all resident and staff working the frontlines, and access to enough lifesaving personal protective equipment.”

Gov. Charlie Baker, at a State House press conference, acknowledged the challenges being faced by long-term care facilities, but insisted his administration is trying to address them. “My dad’s in one of these facilities so I take this stuff pretty seriously,” he said.

Baker also revealed that the state is preparing to open closed nursing facilities and repurpose them to serve COVID-19 patients exclusively. An earlier plan to move existing patients out of nursing facilities and replace them with patients with COVID-19 was abandoned when the current residents were tested for the coronavirus and many turned out to have the disease.

Baker and Lt. Gov. Karyn Polito apparently plan to host a press conference on Tuesday at one of these new, repurposed facilities on Cape Cod.

Baker said long-term care facilities are the most challenging to deal with because of the vulnerable population they serve and the close contact employees have with residents. But he said a fairly recent mobile testing effort administered by the National Guard has found that 201 facilities have at least one case of COVID-19, which he said means roughly 800 have no cases. Industry officials, however, say many of the residents of those other facilities have not been tested yet.

Baker indicated his administration is aggressively tackling the problem. “I actually think we’ve taken pretty seriously the importance of coming up with strategies to do all we can…to try to protect people to the best of our ability in senior care and congregate care facilities,” he said.

Nursing homes have emerged as the frontline in the battle against COVID-19 since Friday, when state officials for the first time released data indicating residents of nursing homes are dying at alarming numbers. The data indicate 45 percent of the state’s COVID-19 deaths have occurred in nursing homes. As of Monday, a total of 378 residents and staff at long-term care facilities had died of COVID-19.

Adam Berman, the president of Chelsea Jewish Lifecare, which operates two nursing homes in Chelsea and one in Peabody, said he was surprised at Baker’s comment that most of the state’s long-term care facilities are COVID-19 free. He said many facilities are still waiting for testing and others don’t provide nursing care. He also noted the two-to-three-day delay between doing the testing and getting results only exacerbates the problem.

Berman said the National Guard was scheduled to do testing at his facilities two weeks ago, but canceled on the scheduled day. Rather than wait for a new date, Berman’s company arranged to have a private company come in to do testing. Over the weekend, he disclosed on the company’s website that 117 of 251 residents and 40 of 103 staff members at the three facilities tested positive for COVID-19. Many of those who tested positive were in stable condition and asymptomatic, but 11 residents died of the virus.

“The way that this virus spreads is unlike anything we’ve ever seen before,” said Berman, who noted that his company never had a flu outbreak in more than 100 years of existence.

In her letter to the top political leaders on Beacon Hill, Gregorio said 40 percent of staffing positions at nursing homes are vacant because the employees have either contracted COVID-19, are quarantining due to exposure to it, “or they simply fear coming to work.” She said the state’s nursing homes need to hire about 17,000 people “to reach a basic staffing level.”

Gregorio said state resources are needed “to offer a double-time ‘hero’s pay’ during this unprecedented crisis.” She said the Baker administration ‘s decision to boost essential provider rates by $13 million per month was helpful, but it is not enough. She said an extra $130 million a month is needed.

“Without this, many or most nursing homes will not have the finances to survive this crisis and pay their staff,” she said.

“Simply put, despite our many pleas, nursing facilities simply have not been given and do not have the resources to fight this pandemic without more support from the Commonwealth. COVID-19 is utterly depleting our nursing home community in every way. If we are to have any success, we immediately need the Commonwealth, hospital systems, and our local communities to join us on the frontline,” she said.