Goldfeder and Bedzow: Coronavirus nursing home crisis – 4 things they need right now

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As of today, nearly1 2,000 people have died from the coronavirus at U.S. nursing home facilities. Tens of thousands more residents, in thousands of homes across the country, have also been infected.

These are the confirmed cases; the actual numbers are likely much higher, and these elderly patients are the most susceptible to the virus and the most likely to have comorbidities.

Supplies are running low and staffing is impossible, as those caretakers who have been infected or exposed must themselves be quarantined for safety.

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This is a national emergency inside of a national emergency. Congress needs to act now.

Last week, President Trump and Vice President Mike Pence shared their concerns about the nursing home community and committed to increasing testing at these facilities. That is great, but Congress needs to do more, and fast, because hundreds of thousands of lives are at stake, and not just those who are in homes.

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The senior living industry is serving as a backstop against the surge of people coming to America’s hospitals. So, in a very real sense, our entire health care system is depending on this industry’s continued success in disease mitigation and infection control. Failure on the front lines will result in increased hospital admissions, straining already limited health care resources.

In order to continue protecting the millions of seniors in senior living communities, not to mention the health care infrastructure they are buttressing, these communities need to have their funding explicitly included in federal relief packages. The initial $30 billion from the Public Health and Social Services Emergency Fund, which is designated for health care providers in the recently passed CARES Act, was overwhelmingly focused on hospitals. In fact, more than 95 percent went to other health care providers.

In addition, unlike restaurant chains, nursing facilities were not excluded from the Small Business Administration’s affiliate rules and were ineligible for Paycheck Protection Program  (PPP) loans under the CARES Act.

Like hospitals, these facilities have played heroic front-line roles in caring for the frailest among us, despite tremendous hurdles in obtaining equipment and staff,

These communities need four things, and they need them yesterday.

First, they need priority access to PPE and testing (for symptomatic and asymptomatic residents and staff). Thankfully, President Trump has agreed to provide this.

Second, they need Health and Human Services to specifically allocate money for senior living communities. Costs are skyrocketing related to added staffing, purchasing added infection control supplies and expanding operations.

A third-party analysis procured by Argentum and the American Seniors Housing Association (ASHA) shows that the increase in non-labor costs (infection control supplies and PPE) for a community without a COVID-19 positive case can be up to 73 percent. For communities with a COVID-19 diagnosis, it can be up to 103 percent.

Third, they need to be able to access the PPP loans. On average, labor costs have increased up to 8 percent for senior living communities that remain COVID-19 free and up to 18 percent for COVID-19 positive senior living communities. Communities are hiring additional employees to provide added services and are paying overtime and hero bonuses.

Meanwhile, lost revenue is estimated at around 8 to 23 percent. Because of COVID-19, communities cannot continue move-ins or use the revenue from new residents to counteract these expenses. All in all, lost revenue and an increase in expenses are projected at $40 billion to $57 billion over the next year. This means that many homes will fail.

Fourth, they need guaranteed protections from liability for COVID-19 related fatalities. On top of soaring costs and plummeting revenues, plaintiffs’ lawyers are already waiting to attack with countless lawsuits seeking to blame nursing homes and assisted living facilities for asserted COVID-related fatalities.

Like hospitals, these facilities have played heroic front-line roles in caring for the frailest among us, despite tremendous hurdles in obtaining equipment and staff, in the face of opaque directives from regulators, and at times under instruction to accept positive or presumed positive residents. These lawsuits would cripple the industry.

The costs of defending against, let alone bearing liability for, baseless accusations arising of unavoidable circumstances would be in the billions, and would not benefit the American people. The industry needs protection against liability in order to survive.

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In a statement released Thursday, the European director of the World Health Organization said up to half of the 110,000 coronavirus deaths that happened in Europe happened in nursing homes, where the staff was overworked, underpaid and without the protective gear and support that they needed.

We cannot let that happen here. Industry leaders have been begging Congress to help for weeks but as of yet, there has been no specific relief. There is simply no more time to waste.

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Dr. Ira Bedzow is an associate professor of medicine, the director of the Biomedical Ethics and Humanities Program, and head of the UNESCO Chair in Bioethics at New York Medical College.