Reps. Eshoo and Shalala Demand Answers from CMS about Efforts to Stop Spiraling COVID-19 Death Toll Among Nursing Home Residents

May 4, 2020
Press Release

WASHINGTON, D.C. – Energy and Commerce Health Subcommittee Chairwoman Anna G. Eshoo (CA-18) and Representative Donna Shalala (FL-27) today sent a letter to the Administrator of the Centers for Medicare and Medicaid Services (CMS) Seema Verma demanding answers about the agency’s efforts to stop the spiraling COVID-19 death toll among nursing home residents. As of May 1, 2020, more than 16,000 residents and staff have died from COVID-19 infections in long-term care facilities. More than 1 in 6 facilities nationwide are publicly acknowledging infections among residents or staff.

“COVID-19 has exposed and amplified our profoundly flawed system of caring for older adults,” the lawmakers wrote. “Structural failings in the long-term care industry are contributing to infections and deaths. Nearly 10,000 nursing homes in the U.S. have been cited for infection control failures such as staff not washing hands or cleaning soiled bed sheets. More than half a million residents live in nursing homes rated “average” or “below average” by your agency. Nursing homes are also chronically understaffed. About 75% of the nation’s nursing homes do not meet the federal suggested minimum levels for staffing. These staffing levels are further decreasing as underpaid nursing home staffers are asked to risk their health without the guarantee of proper [personal protective equipment] PPE or the ability to readily test.”

The lawmakers voiced concerns that the nation’s nursing homes lack timely access to the testing kits to conduct continued surveillance testing in these vulnerable settings. In addition, given the rapid and asymptotic spread of the virus, the lawmakers noted that nursing homes must have the proper PPE for staff and residents, but nursing homes are experiencing a shortage of critical supplies.

Since 2017, CMS has issued multiple deregulatory policies to reduce infection control requirements, lessen fines against nursing homes, and ended a ban on arbitration agreements, which limits the ability of patients or family members to sue a nursing home for injuries or death and their ability to disclose injuries to the public.

“Your agency is responsible for ensuring long-term care facilities meet federal quality standards, but it has repeatedly weakened quality regulations and penalties for nursing homes,” the lawmakers wrote.

As part of their inquiry, the lawmakers requested answers to a series of questions, including:

  • Will CMS commit to withdrawing the July 18, 2019 proposed rule which repeals infection control regulations?
  • How is CMS working across the federal government, including with Federal Emergency Management Agency (FEMA) and the Assistant Secretary for Preparedness and Response (ASPR), to secure the needed testing capabilities for long-term care facilities?
  • Is CMS enforcing isolation protocols so that COVID-19 positive residents are cared for in separate facilities or units?
  • How is CMS working across the federal government to secure the needed PPE for long-term care facilities?
  • How is CMS assessing whether long-term care facilities are protecting their residents and staff from infection?
  • On what date will CMS and CDC make COVID-19 reporting data from long-term care facilities public? On what website will this data be made available to the public? How often will CMS and CDC update that public data on the website?
  • With nursing home surveys severely limited, how is CMS ensuring that long-term care facilities are following COVID-19 guidance and safety requirements?
  • How is CMS aiding long-term care facilities in ensuring that virtual visitation is available to residents and their families?

To read the letter, click HERE.