WASHINGTON D.C. (KXAN) — Frustrations boiled over in a special subcommittee hearing on nursing homes, as U.S. lawmakers discussed the spread of COVID-19 among these vulnerable elderly populations — and how to stop it.
Lawmakers on the House Ways and Means Health Subcommittee pointed fingers at the Trump administration, New York Governor Andrew Cuomo, the nursing homes themselves, and, more often than not, the federal agency that regulates them.
“Give us what you’ve done about these report cards, or else every one of you should be fired, from the top to the bottom!” yelled Representative Bill Pascrell of New Jersey. “I’ve had relatives who have died in these homes, and I’m not going to leave this alone.”
He was referring to Centers for Medicare and Medicaid Services infection control inspection reports, as well as federal coronavirus data now required to be reported by the homes each week.
Ahead of the hearing Thursday morning, Rep. Lloyd Doggett (D-Texas) told KXAN Investigators their reporting on the crisis in long-term care facilities prompted him to call for more meaningful change.
“I think we have a real nursing home crisis,” Doggett emphasized.
Rep. Doggett chaired the subcommittee hearing and pointed out that more than 800 homes still have not reported the required data to CMS. He said many of those homes are in Texas.
KXAN Investigators found 117 Texas homes with no data reflected, out of the 831 total homes that had not reported — more than any other state.
“We don’t have the information we need to make good policy or to protect families,” he said, emphasizing the importance of hearing from experts in Thursday’s hearing.
Harvard Professor and witness Dr. David Grabowski testified that the lack of transparency in the federal data was not only concerning, but hindered the ability to adequately respond to the crisis.
“The other problem with not having early data was not being able to learn… about which facilities have cases, and which don’t. What’s working in terms of best practices?” Dr. Grabowski said. “This really prevented us from any type of learning.”
Austin resident Delia Satterwhite testified about the frustration she felt when trying to get answers about her brother in a nursing home, days before he died.
“It felt like they were keeping a secret. No one wanted me to know what was happening,” she said. “My brother should still be alive.”
A lack of transparent reporting was not the only deficiency discussed at Thursday’s meeting.
“We have seen, for 30 years now the standard of sufficient nurse staffing, and it’s not enough,” Senior Policy Attorney for the Center for Medicare Advocacy Toby Edelman said. “What we see a lot is that nurse aids have not just 15 people, but 20 to 25 residents they are responsible for.”
Experts highlighted the difficulties of the job, and the sacrifices these employees make.
A Connecticut nursing home employee testified to working twelve hour days regularly during the outbreak.
“There were many days I came home crying,” Melinda Haschak said. “Today, we are still understaffed, over worked and still do not have enough PPE. While I appreciate the donations of food and the occasional pizza party — we do not need a pizza party, we need PPE.”
Edelman emphasized a need for more “sufficient” staffing requirements and more oversight on infection prevention in the homes.
“People are dying in nursing homes because people are not washing their hands,” she said, noting that employees sometimes have to “cut corners” when they are short-staffed.
Dr. David Grabowski suggested offering increased pay to workers and better benefits. In many states, ‘hazard pay’ is not being offered to nursing home workers, while other health care workers are seeing benefits.
Lawmakers argued that federal agencies should have been better prepared to handle the crisis in nursing homes after the outbreak at a facility in Kirkland, Washington.
“It took FEMA some 61 days, two months, to get out its directive concerning personal protective equipment for nursing homes. When the equipment finally came from FEMA, much of it was junk,” Doggett said. “Frequently was unusable — glorified trash bags for gowns and cloth masks instead of N95 masks.”
He argued it took even longer to get adequate testing to these homes, and that some homes still haven’t completed any testing.
Several lawmakers argued that rules in some states allowing coronavirus patients back into these homes exacerbated the spread.
“If we are to ensure our nation’s parents and grandparents are protected moving forward, we need to fully understand why Governor Cuomo and the four other governors ordered COVID-19 positive seniors to be forced into nursing homes, exposing the entire nursing home population and staff to death,” said Rep. Tom Reed (R-NY).
Dr. Grabowski agreed this policy was a “mistake,” but after some tense moments with Rep. Reed, he also stated that the policy was “consistent” with federal guidance.
- Watch the full meeting or read the witness testimony here.
Rep. Doggett told KXAN they requested testimony from Seema Verma, the Administrator for the Centers for Medicare and Medicaid Services, to answer some of these questions. He said they offered multiple dates and times, but the agency declined to offer any witness for the hearing.