Showing: 1 - 10 of 12 RESULTS

Infection Control Problems Persist in Nursing Homes During COVID


The new analysis draws on self-reported data from nursing homes collected by the federal government over four weeks from late August to late September. While some states fared much worse than others, all 50 states and the District of Columbia had one or more nursing homes that reported inadequate PPE supply, staff shortages, staff infections and resident cases. Forty-seven states reported at least one COVID-19 death among residents.

The analysis found that more than 28,000 residents tested positive for COVID-19 during the four-week reporting period, and more than 5,200 residents died, showing that the virus is still raging in nursing homes. More than 84,000 long-term care residents and staff have died since January, and more than 500,000 residents and staff have contracted the disease, according to the Kaiser Family Foundation’s tally, accounting for roughly 40 percent of the national death toll. Long-term care providers include assisted living, adult day care centers and more, while AARP’s new analysis features just nursing home data.

“This is a nationwide crisis, and no state is doing a good job,” says Bill Sweeney, AARP’s senior vice president of government affairs, adding that the results of AARP’s analysis are “profoundly disappointing.”

“While the pandemic has been unexpected to all of us, basic infection control should have been going on in nursing homes for a long time,” he says. “These are places where people are vulnerable to infection, whether it’s COVID or something else, so for these facilities to still not have basic PPE, even now, with a deadly virus in the air, is outrageous and unacceptable.”

Staff infections nearly match resident infections

For months, providing adequate PPE and developing plans to mitigate staffing shortages have been “core principles” set out by the Centers for Disease Control and Prevention (CDC), for COVID-19 infection control in nursing homes, which generally house older adults with underlying conditions who are at increased risk of infection and severe illness from the disease. PPE stops the transfer of infectious droplets through the air, while adequate staffing ratios mean better care and less person-to-person contact.

Yet in 18 states, more than 30 percent of all nursing homes reported PPE shortages, and in 26 states and the District of Columbia, more than 30 percent of nursing homes are experiencing staff shortages. N95 respirators were the most in-demand PPE item across the country, with 11 percent of all nursing homes reporting shortages. And nursing home aides (certified nursing assistants, nurse aides, medication aides and medication technicians) were the most in-demand staff, with 27 percent of all nursing homes reporting shortages.


Source Article

More than 100 N.J. nursing homes have had coronavirus outbreaks since summer as crisis continues

The coronavirus devastated New Jersey’s nursing homes this spring, killing thousands of residents and prompting a raft of measures to better protect the state’s most vulnerable population.

Since that time, long-term care facilities say they have stockpiled personal protective equipment. They’ve developed protocols for testing residents and staff and isolating those who are sickened. Visitors continue to be limited by state regulators, amid fears the virus will be reintroduced as families reunite with their loved ones.

Yet despite those precautions, the coronavirus continues to creep into the state’s nursing homes, assisted-living centers and other senior facilities, even among those that managed to eradicate their original outbreaks, Department of Health data shows.

Across New Jersey, at least 102 long-term care facilities saw new outbreaks this summer or fall after being declared COVID-19 free, according to a review by NJ Advance Media. Included in those were 11 facilities in which residents or staffers died in the new contagions.

That points to a somber reality as New Jersey grapples with a concerning resurgence of coronavirus in recent weeks: Even as nursing homes have had nearly seven months of experience combating the virus, many remain unable to keep it wholly at bay. Still, those outbreaks are proving less deadly and easier to contain than in March or April, when underprepared facilities were floored by a pandemic that caught them, the state and the country flat-footed, flooding New Jersey’s hospitals and morgues.

On Friday, a union that represents 8,000 nursing home workers in New Jersey expressed concerns about a second wave of the disease and the impacts it could carry.

“Nursing home operators need to be taking every precaution, including giving frontline workers access to n95 masks, gowns and surgical masks before, not after, new outbreaks emerge,” said Milly Silva, the executive vice president of 1199SEIU United Healthcare Workers East. “Facilities need also to staff-up now, to prevent the type of short-staffing crisis that we experienced earlier this year.”

James McCracken, who heads a trade association of nonprofit senior care organizations, called preparedness a difference of “night and day” from what it once was. Nursing homes have learned to better protect residents and staff, he said, and have largely secured the personal protective equipment that was in such short supply.

“It’s pretty clear that there’s just a much better understanding of the disease, which no one had in the beginning, which was new to everyone,” said McCracken, the chief executive of LeadingAge New Jersey & Delaware.

But seniors and the workers who care for them do continue to be sickened and die, if at rates far lower than at the height of the disease’s sweep. It takes just one positive test for a nursing home to be considered to have a new outbreak, and in many cases, those small-scale infections are not spreading.

The state began publishing an online list of infections and deaths by facility in April after complaints that nursing homes were not being transparent as the disease ripped through New Jersey. But

Nevada Revokes Halt on Rapid Antigen Testing in Nursing Homes

A week later, however, Admiral Giroir cracked down on Nevada’s “illegal” prohibition on BD’s and Quidel’s tests, which he said had imperiled the residents and staff of nursing homes across the state. “They cannot supersede the PREP Act,” he said.

The false positives that had emerged, Admiral Giroir said, were not only expected but “actually an outstanding result.” No test is perfect, he said.

In the Nevada statement, Dr. Azzam reaffirmed his concerns with the number of false positives that had arisen. “If this laboratory data discrepancy had been reported to Dr. Giroir, we would hope he would have taken the same action as Nevada,” he said. “We too want more testing with rapid turnaround in Nevada, but the results of those tests must be accurate, as they affect clinical care.”

The state’s nursing facilities can resume use of BD’s and Quidel’s products, according to a new Nevada directive issued on Oct. 9. But Nevada’s department of health also recommended that all antigen test results, positive or negative, be confirmed by a laboratory test that relies on a slow but very accurate and reliable technique called polymerase chain reaction, or P.C.R. False negatives, officials noted, risk exposing healthy people in nursing homes to someone who is unknowingly contagious. False positives, on the other hand, could prompt the placement of a person who is well into a unit with sick people, also increasing the chance of infection.

“Both of these scenarios could result in causing harm to a population that we have collectively worked so hard to protect,” the directive said. State health officials, it said, would also continue to investigate the use of BD’s and Quidel’s products.

“We need to better understand the issue before encouraging mass use of such tools among our most vulnerable citizens,” Dr. Azzam said. “We are not saying the tests have no use, we are just saying pause for further review and additional training.”

In a statement, Admiral Giroir said he and his colleagues were “pleased” about Nevada’s reversal. “This serves as a valuable public policy discussion that benefits the public interest by deterring unilateral prohibitions or similar actions in other states or jurisdictions,” he said.

Source Article

Federal Official Threatens Nevada for Halting Rapid Tests in Nursing Homes

The leader of the nation’s coronavirus testing efforts condemned Nevada’s health department on Friday for ordering nursing homes to discontinue two brands of government-issued rapid coronavirus tests that the state had found to be inaccurate.

“Bottom line, the recommendations in the Nevada letter are unjustified and not scientifically valid,” Adm. Brett Giroir, an assistant secretary of Health and Human Services, said in a call with reporters on Friday. The state’s actions, he said, were “unwise, uninformed and unlawful” and could provoke unspecified swift punitive action from the federal government if not reversed.

The rapid tests, which were distributed to nursing homes around the country in August by the federal government, were supposed to address the months of delays and equipment shortages that had stymied laboratory-based tests.

“The important issue is to keep seniors safe,” Admiral Giroir said in an interview on Friday. Antigen tests, he added, were “lifesaving instruments” that had been called “godsends” by some nursing home representatives. About 40 percent of the country’s known Covid-19 deaths came from nursing homes, according to a New York Times analysis.

But Nevada officials had discovered a rash of false positives among two types of rapid tests, manufactured by Quidel and Becton, Dickinson and Company, that had been used in the state’s nursing homes. Both tests look for antigens, or bits of coronavirus proteins, and had been advertised as producing no false positives.

Among a sample of 39 positive test results collected from nursing homes across the state, 23 turned out to be false positives, the state reported. (The bulletin did not specify whether negative results from the antigen tests, of which there were thousands, had been confirmed, leaving the number of false negatives unknown.)

“I would consider that to be a significant number of false positives,” said Omai Garner, a clinical microbiologist at the University of California, Los Angeles.

Admiral Giroir contended that such rates of false positives are to be expected, and are “actually an outstanding result.” No test is perfect, he said.

He also said that the federal government expected the state to promptly rescind its unilateral prohibition, which he described as a violation of the Public Readiness and Emergency Preparedness Act.

An Aug. 31 guidance from Admiral Giroir’s office stipulated that PREP Act coverage “preempts” states from blocking the use of coronavirus tests that have been authorized by the Food and Drug Administration on people in congregate settings, like nursing facilities.

What Nevada has done is “illegal,” he said. “They cannot supersede the PREP Act.”

The federal government’s formal response to Nevada’s health department, dated Oct. 8 and signed by Admiral Giroir, portrayed the state’s officials as scientifically incompetent and their actions as “improper” under federal law. “Your letter can only be based on a lack of knowledge or bias, and will endanger the lives of our most vulnerable,” Admiral Giroir wrote.

Should the state hold its ground, “there can be penalties from the federal side,” he said in an interview on Friday, but declined to provide details.

Coronavirus relief funds for nursing homes dry up, raising fears for elderly, vulnerable

As drafts of a renewed coronavirus relief package continue to be debated in and around the White House, the many millions left languishing in nursing homes and elderly care facilities – along with their loved ones forced to communicate with them from afar – are urging swift action.

According to the American Health Care Association (AHCA), almost all the initial $175 billion U.S. Department of Health and Human Services (HHS) funds from the CARES Act – which was signed into law by President Trump in late March – has been spent, and yet coronavirus – officially termed COVID-19 – cases in at least 22 states continues to ascend, ahead of the already daunting cold and flu season.

“HHS has announced distribution plans for 80 percent of the $175 billion Provider Relief Fund created by the CARES Act. Health care providers, including nursing homes, will need additional resources to continue its response to the COVID pandemic heading into the cold and flu season, which provides new challenges,” Mark Parkinson, president and CEO of American Health Care Association and National Center for Assisted Living (AHCA/NCAL), told Fox News. “COVID-19 disproportionately impacts the elderly – many of whom already have preexisting health conditions and chronic diseases – and the dedicated staff who care for them.”

AMID CORONAVIRUS, 1 IN 4 AMERICANS ARE FAILING TO WASH THEIR HANDS: CDC

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) has thus requested an additional $100 billion from the HHS Provider Relief Fund, which is accessible for all health care providers impacted by the novel pathogen, and asked “that a sizeable portion of the fund be dedicated to helping nursing homes and assisted living communities to acquire resources associated with protecting vulnerable residents and staff from the virus, including constant testing, personal protective equipment (PPE) and staff support.”

Parkinson is urging Congress to provide the additional billions to protect the most susceptible. As of Friday, the notion of further stimulus and relief funding was still the topic of political fodder in Washington.

Parkinson emphasized that the PPE supply shortages and delays in obtaining test results in the first six months of the pandemic “put nursing homes at a serious disadvantage” in keeping COVID out of their facilities.

 “Funding from HHS has helped nursing homes pay for additional staffing, secure vital PPE equipment, and conduct regular testing of residents and staff in response to the COVID pandemic,” he lamented. “We need Congress to prioritize our vulnerable seniors and their caregivers in nursing homes and assisted living communities by passing another COVID-funding package before they leave town for the elections.”

Indeed, a prominent portion of coronavirus deaths have occurred in nursing homes and assisted living facilities nationwide – a chilling consequence of the disease, which is known to be especially lethal to adults over the age of 60, and with underlying health ailments. Furthermore, it can rapidly tear through converging, indoor dwellings and be passed on by workers who move from room and room.

CLICK

Nevada Halts Use of Rapid Coronavirus Tests in Nursing Homes, Citing Inaccuracies

Kristen Cardillo, BD’s vice president of global communication, said the company was aware of the situation in Nevada and was “conducting thorough investigations.” She added that “based on the information in the directive and the total tests performed, we believe the rate of reported false positives is well within what we would expect for the BD Veritor System.”

Representatives for the Department of Health and Human Services did not respond to requests for comment.

Concerns have also been raised about the ability of antigen tests to accurately pinpoint infections, especially if administered during a period when a person harbors low levels of the coronavirus. BD’s test is advertised as having a false negative rate of 16 percent. Quidel’s is just above 3 percent. The directive from Nevada’s department of health did not report whether the negative antigen test results from nursing homes — there were nearly 3,700 such results — had been confirmed by P.C.R.

In a call with LeadingAge members on Monday, Adm. Brett Giroir, who has been leading the nation’s testing efforts, said antigen tests were “clearly a lifesaving option,” and for many facilities the best test available, given the delays, expenses and shortages that had plagued P.C.R. tests.

“It is perfectly acceptable for congregate care, particularly nursing homes, to use an antigen test, even if they are, quote, off-label,” Dr. Giroir said in the interview. “Just because they don’t have an authorization doesn’t mean they’re not good for it.”

In response to questions about false positives, Dr. Giroir reminded LeadingAge members that in places where the coronavirus is scarce, false positives should be expected to outnumber true positives and do not necessarily invalidate the usefulness of a test. “That’s a function of the way life is,” Dr. Giroir said.

The halt to antigen testing in Nevada’s nursing homes comes just days after health experts criticized the White House, which is now in the midst of a coronavirus outbreak, for a misguided overreliance on rapid testing. For months, officials used two products made by Abbott Laboratories, the ID NOW and the BinaxNOW, to test people without symptoms — another off-label use — while eschewing masks and physical distancing. In September, the White House also began distributing millions of BinaxNOW tests to communities across the country, including nursing homes around the country.

Source Article

Relaxed regulations have calming effect on Cy-Fair area nursing homes

After a heart-breaking five months of isolation, seniors in area nursing homes and assisted living centers have some new options for seeing their loved ones.

At a press conference on Sept. 17, Gov. Greg Abbott announced a new visitation guidance for eligible nursing homes, assisted living facilities, intermediate care facilities, home and community-based service providers, and inpatient hospice effective Thursday, Sept. 24.

“I certainly applaud Gov. Abbott and the HHSC (Health and Human Services Commission) on working to reduce and relieve some of the restrictions with visitation,” said Derek Prince, CEO HMG Healthcare who manages Park Manor of CyFair.


“We value the psycho and social well-being and family relationships,” he said. “It’s been extremely trying for our patient population and our families. We’re excited to be able to put this stuff together,” he said.

With the relief comes a bit of grief as well.

“They are also burdensome and duplicitous from the guidance we received from CMS (Centers for Medicaid and Medicare Services). It’s somewhat confusing at times,” he said.

“Slowly but surely we’re getting our arms around it and hopefully making a difference” the CEO said.

Prince described the visits under two categories: a regular visitor policy and an essential care worker designation.

Under the regular visitor policy, they are based on county positivity rates whether they are designated as indoor or outdoor visits. They can consist of outdoor no contact visits, open window visits, or indoor visitation with the use of plexiglass safety barriers, all attempts at preventing the spread of the coronavirus. There can be no physical contact between residents and visitors.

“Those can be scheduled by any loved one on our website with the Schedule A Visit button at an appropriate time,” he said.

The visits are allowed seven days a week and they allow for cleaning between each visit.

The potential is there for those visits to be taken away in the event of a breakout with patients or even staff.

The second category is an essential care worker designation. A resident or responsible party can designate two essential caregivers for each resident. They’re not required to adhere to social distancing. There can be contact and touch and can be in a patient’s room. Staff and other residents are still required to socially distance with the visitors.

“On the front end we have to provide training for all of the essential caregivers on facility policies and procedures regarding infection control, PPE, and hand hygiene. They still have to go through testing protocols to make sure they are safe,” Prince said.

Only one caregiver can visit a resident at a time. Some facilities place a time requirement on that from 30 minutes to an hour. Proper PPE must be used at all times during these scheduled visits, and the caregiver must test negative for COVID-19 within the previous 14 days

Gov. Cuomo falsely claims New York nursing homes ‘never needed’ to take in Covid-positive patients

New York Gov. Andrew Cuomo said that nursing homes “never needed” to accept Covid-positive patients from hospitals in the state due to a shortage of hospital beds.



Andrew Cuomo wearing a suit and tie: NEW YORK, NY - JULY 23: New York Gov. Andrew Cuomo speaks during the daily media briefing at the Office of the Governor of the State of New York on July 23, 2020 in New York City. The Governor said the state liquor authority has suspended 27 bar and restaurant alcohol licenses for violations of social distancing rules as public officials try to keep the coronavirus outbreak under control. (Photo by Jeenah Moon/Getty Images)


© Jeenah Moon/Getty Images North America/Getty Images
NEW YORK, NY – JULY 23: New York Gov. Andrew Cuomo speaks during the daily media briefing at the Office of the Governor of the State of New York on July 23, 2020 in New York City. The Governor said the state liquor authority has suspended 27 bar and restaurant alcohol licenses for violations of social distancing rules as public officials try to keep the coronavirus outbreak under control. (Photo by Jeenah Moon/Getty Images)

During a press call Wednesday, Finger Lakes News Radio asked Cuomo about his administration’s advisory in late March requiring that nursing homes accept the readmission of patients from hospitals, even if they were positive for Covid-19.

The governor’s office has repeatedly said the advisory was based on federal guidance, which prohibited discrimination based on a coronavirus diagnosis. The state’s Department of Health told CNN, “Residents were admitted to nursing homes during that time not as an overflow facility, but because that’s where they live.”

Cuomo said that the advisory was a precaution if hospitals became overwhelmed — calling it an “anticipatory rule” — which he said didn’t happen.

“We never needed nursing home beds because we always had hospital beds,” Cuomo told Finger Lakes News. “So it just never happened in New York where we needed to say to a nursing home, ‘We need you to take this person even though they’re Covid-positive.’ It never happened.”

Facts First: Cuomo’s assertion that “it never happened” is false. According to a report from the New York State Department of Health, “6,326 COVID-positive residents were admitted to [nursing home] facilities” following Cuomo’s mandate that nursing homes accept the readmission of Covid-positive patients from hospitals. Whether or not this was “needed,” it did in fact happen.

Cuomo’s senior adviser Rich Azzarpodi replied Thursday after publication and took issue with this determination, saying that the governor was specifically referencing the hospital bed shortage. “The governor was crystal clear, he was saying that what did not materialize was the crunch for hospital beds, that every projection especially the federal governments projections predicted was going to happen. That’s what he said never happened. Separately the law has always been that nursing homes could only accept residents that they could adequately care for. None of that has changed.”

On March 25, the state’s Health Department issued an advisory requiring nursing homes to accept “the expedited receipt of residents returning from hospitals” if the patients were deemed medically stable.

“No resident shall be denied re-admission or admission to the [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19,” the advisory stated. “[Nursing homes] are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.”

This mandate received a great deal of criticism, and Cuomo issued an

New Jersey Veterans Homes Likely Failed to Acknowledge Covid-19 as Cause in Dozens of Deaths, Officials Say

A state-run nursing home for veterans in New Jersey failed to attribute nearly 40% of its likely Covid-19 deaths to the virus, according to the state’s own Department of Health.

The Menlo Park Veterans Memorial Home, in Edison, N.J., attributed 62 deaths to the new coronavirus on the website of the state’s veterans’ affairs agency. But a Department of Health spokeswoman, Nancy Kearney, said late Wednesday that an additional 39 people probably died from the virus at the facility during a wave of infections there.

Another state-run veterans home, in Paramus, N.J., also likely had more Covid-19 deaths than the total it attributed to the virus, Ms. Kearney said. The likely undercount at the two facilities, among the deadliest in the state for the virus, was first reported by The Wall Street Journal.

The findings show how publicly reported nursing home mortality figures can fail to reflect the true toll the pandemic has taken on the facilities, which are home to some of the most virus-vulnerable people in the country.

A spokesman for the New Jersey Department of Military and Veterans Affairs, Kryn Westhoven, in a statement released Wednesday, said his agency “mourns each and every veteran that passes away in our Memorial homes…. Much like other long-term care facilities across the state and country, Covid-19 created unprecedented circumstances and demands within our veterans memorial homes. During this time, all deaths were reported to the Department of Health.”

The New Jersey Veterans Home at Paramus, another state-run home for former members of the U.S. military, originally reported 81 Covid-19 deaths.



Photo:

timothy a. clary/Agence France-Presse/Getty Images

The two state-run nursing homes have faced a barrage of criticism from families of deceased residents. The Paramus facility, which initially reported more deaths, has in particular come under fire.

In the early days of the pandemic, testing wasn’t widely available to residents at many facilities. A large number of deaths at Menlo in April, the peak of that facility’s outbreak, were attributed to other causes, such as pneumonia, even as the death toll soared above usual levels.

The Paramus facility reported 81 deaths linked to Covid-19. The health department’s Ms. Kearney said an additional eight patients at that facility probably died from the virus.

The state counted as probable deaths those that weren’t clearly explained by another cause where patients had Covid-19 symptoms, or autopsies found signs of Covid-19, Ms. Kearney said in an email, as well as some other types of deaths.

Veterans agency records viewed by the Journal show nearly 100 people died at the Menlo facility in April alone. That’s about as many as the facility typically loses in a year, historical records show.

Mr. Westhoven also said in an earlier interview that the department only counted deaths when a death certificate expressly listed Covid-19 as the cause. That accounting missed some cases where residents tested positive but still didn’t have Covid-19 listed on their death certificates.

William Hefele, a Navy veteran and Menlo resident, was hospitalized in early April

Alabama nursing homes to allow limited in-person visits

Alabama Gov. Kay Ivey announced Wednesday the resumption on Oct. 2 of limited in-person visits to nursing homes more than six months after they locked down in response to coronavirus.

Each nursing home resident will be allowed one caregiver or visitor at a time. Nursing homes can only permit indoor visits if they have not had a positive coronavirus case in two weeks, according to the Alabama Nursing Home Association. Facilities can limit the total number of visitors at one time and masks and social distancing will be required.

The Alabama Nursing Home Association provided the following guidance to family members:

· Do schedule an appointment to visit with your loved one

· Do use alcohol-based hand sanitizer before, during and after your visit

· Do wear a mask covering your mouth and nose during your entire visit in the facility

· Do maintain social distance of at least six feet from staff and residents

· Do keep out of areas that are not designated for visitation

· Don’t remove your mask while in the facility

· Don’t leave the designated visitation area

· Don’t come to the facility without an appointment

· Don’t come to the facility if you have any symptoms – coughing, sore throat, fever, vomiting, diarrhea, loss of sense of taste or smell – even if you attribute these symptoms to some other cause (allergies or cold).

More than 6,000 nursing home residents and 3,000 staff members in Alabama have been diagnosed with COVID-19 since March. The facilities often house sick and elderly people at high risk of complications and death from the virus. But families have become increasingly concerned that policies designed to protect vulnerable residents have caused cognitive and physical decline as they struggle with isolation and loneliness.

“It’s important for nursing home residents and their family members to be able to visit in person and this is another step toward returning life to normal in nursing homes,” said Brandon Farmer, President & CEO of the Alabama Nursing Home Association. “We are pleased [the Centers for Medicare and Medicaid Services] is moving in this direction and thankful Governor Kay Ivey and Dr. Scott Harris amended the state health order to accommodate this change.”

Some Alabama nursing homes have scheduled outdoor visits with family members. However, state regulators did not require outdoor visits or video calls with loved ones. The new guidelines require facilities to accommodate visits unless there are reasonable safety concerns.The Centers for Medicare and Medicaid Services (CMS) said outdoor visits are preferable to indoor ones and should be encouraged whenever conditions allow.

Anna Braden of Huntsville joined the Alabama group Caregivers for Compromise to advocate for visits with nursing home residents, including her father, who lives in Madison. She said the announcement is a step in the right direction.

“This is the first time that Governor Ivey has ever said anything about the residents on lockdown in any of her press conferences,” Braden said. “I was excited about that. Now the next