As death toll in long-term care settings continues to rise, Commission releases inadequate report
WASHINGTON, D.C., September 21, 2020
— The Alzheimer’s Association today called on the federal government to show greater urgency to protect the health and safety of residents living in nursing homes, assisted living and other long-term care settings. The Association said that while the Coronavirus Commission for Safety and Quality in Nursing Homes report provides a roadmap, it fails to provide the practical guidance, tools and funding needed to implement its recommendations adequately and quickly.
“A cornerstone of the solution is clear. It is rapid point-of-care testing,” said Beth Kallmyer, vice president, care and support, Alzheimer’s Association. “Many other institutions ranging from the White House to the Big Ten, NBA, and NFL have recognized the importance of testing and have committed to rigorous protocols to ensure the safety of its athletes; why can’t we do the same for our citizens living in long-term care? The science is clear that they are among the most vulnerable, but certainly we can agree these individuals are no less valuable.”
Since the beginning of the U.S. outbreak, long-term care residents, their family members and staff have been in crisis. Residents are suffering from social isolation and higher death rates. It is estimated more than 77,000 residents and workers have died from the coronavirus at nursing homes and other long-term care communities — representing 40% of all U.S. COVID-19 deaths despite accounting for less than two percent of the population.
The Centers for Medicare & Medicaid Services (CMS) tasked the Commission with identifying recommendations to protect nursing home residents and staff during the pandemic. The report, which includes 27 recommendations and more than 100 action steps, however, neglects to address two important current barriers: CMS doesn’t have the testing supplies, and governors and long-term care settings can’t get the supplies. Notably, of the 25 Commission members, 13 endorsed the final report without reservation, 11 endorsed with reservations, and one member did not endorse.
“Unfortunately we’re already seeing the consequences of the Commission’s inadequate report with CMS’s release of its Nursing Home Visitation Guidelines
which does not require testing of visitors,” said Kallmyer. “The communal nature of these settings combined with the older age and underlying chronic conditions of most residents make the people living there extremely vulnerable to COVID-19. Not testing visitors puts everyone at greater risk.”
Some of the CMS Guidelines conflict with policies states have implemented which require stronger safety measures for visitation, causing confusion for care settings and families. In some instances a state may not allow for visitation consistent with local public health guidance and yet the nursing home may be subject to fines from CMS for not allowing visitation.
The Alzheimer’s Association believes visitors are only appropriate at a long-term care setting when that community employs rapid testing for all staff, visitors and residents, and adequate and consistent access to personal protective equipment (PPE) for all staff.
“This has been an especially difficult time for caregivers and families who have been unable to see their loved ones in person, leading to excess stress. And, there are growing concerns that social isolation among people with dementia has contributed to individual decline and even deaths,” said Kallmyer. “The only way to end social isolation is to ensure every long-term care community has access to and employs rapid testing for staff and visitors.”
The federal government must do more to ensure these residential care settings have the resources needed to protect residents and staff, and provide a gateway to allow visitation for families to end social isolation.
Early in the pandemic, Alzheimer’s Association sounded the alarm, releasing important guidance
highlighting the need for rapid-turnaround testing to ensure COVID-19 does not spread in these settings, and although access to testing has increased, a lack of access to rapid, point-of-care testing equipment and supplies have made it difficult to reopen safely for visitors.
Nationwide, there are more than 15,000 nursing homes and more than 28,000 assisted living communities. According to the Alzheimer's Association 2020 Alzheimer’s Disease Facts and Figures
report, 48% percent of nursing home residents are living with Alzheimer’s or other dementias. Among older adults in residential facilities, including assisted living, 42% or more have some form of Alzheimer’s or other dementias. In addition, many individuals with Alzheimer’s or other dementias receive community-based services, including 32% of individuals using home health services and 31% using adult day services.
The Alzheimer's Association leads the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia.™ For more information, visit www.alz.org or call the 24/7 Helpline at 800.272.3900.
Alzheimer’s Impact Movement
The Alzheimer’s Impact Movement (AIM) is a separately incorporated advocacy affiliate of the Alzheimer’s Association. AIM works to develop and advance policies to overcome Alzheimer’s disease through increased investment in research, enhanced care and improved support. For more information, visit alzimpact.org.