With great fanfare, President Trump announced yesterday that his administration would deliver about two weeks’ worth of masks to nursing homes by the Fourth of July . And he’d stand up a commission to study quality and safety in nursing homes. All just in time to celebrate May as “Older Americans Month.”
The masks apparently are going only to nursing homes. Other care settings such as assisted living facilities, other group homes, or home care agencies won’t get them, even though far more frail older adults live in these community settings than in nursing homes.
The commission, which does not yet have any members, won’t even begin meeting for a month. Those of us who have been around Washington for a while understand that commissions usually are what politicians create when they don’t want to actually do anything.
Senior service providers still are desperately seeking test kits, especially those that rapidly deliver results. Without them, it is impossible to know whether asymptomatic staff or residents are unknowingly spreading the disease among a highly vulnerable population.
The only way we can stop such spread is with widespread testing that delivers results within minutes or at most hours. Those tests exist, but senior living facilities and home care agencies caring for older adults can’t get them. Neither, apparently, can the US Senate.
Advocates for older adults and senior service providers have been begging for personal protective equipment since March. And while Trump’s masks will help, they won’t help very much. Katie Smith Sloan, president and CEO of LeadingAge, the association that represents nonprofit aging services providers, called the White House effort too little, too late: “Nursing homes — and all aging service providers — are in dire need of PPE now. If it came today — which it won’t — it is already more than two months overdue and seriously insufficient.”
Administration officials insist they have been on top of senior living’s COVID-19 issues. CMS Administrator Seema Verma, who heads the Centers for Medicare and Medicaid Services, said in a statement this morning, “CMS has repeatedly taken early unprecedented, aggressive and decisive action to protect nursing home residents during this pandemic.”
The disconnect between those remarks and reality is stunning. The Kaiser Family Foundation reported that, just through April 23, more than 10,000 senior living residents died from COVID-19 in 4,000 facilities—in just the 23 states that reported these deaths. More than 50,000 residents contracted the disease in 29 states.
Even Trump, who rarely acknowledges errors, has called the Administration’s response to the senior living facilities deaths, “a little bit of a weak spot.”
It will take much more than a relatively few masks to address the nation’s deeply flawed system of caring for older adults that COVID-19 has amplified and exposed. A serious commission would help. But not one that only looks narrowly at quality and safety. Those criteria are an absolute bare minimum for delivery of care. But they fall short of providing the best possible quality of life that frail older adults deserve. And that, by the way, may help them avoid costly hospital care.
A serious commission would review everything from the payment system to our models of care to workforce issues to the supports needed by the family caregivers who are the bedrock of the nation’s long-term care system. I hope I’m wrong, but somehow I doubt the president’s commission is going to go there.