An estimated 43 percent of COVID-19 deaths have occurred in assisted living facilities and nursing homes. If reducing deaths is a public health priority, these facilities deserve special attention. In one April week in Connecticut, 90 percent of all COVID-19 deaths occurred in nursing homes.

It’s not unexpected that older Americans would be more likely to experience the worst effects of the virus. Higher rates of underlying conditions, compromised immune systems and other health issues are common in this demographic. But it’s also easy to see how living in close proximity to other at-risk seniors is a significant risk factor in itself.

In the rush to prepare critical care facilities and staff to deal with a potentially overwhelming influx of patients, senior care facilities were neglected. In one instance, nurses at a New York nursing home facility who had tested positive were sent to work with the blessing of the state Department of Health.

Legislators have been proposing a variety of solutions and strategies to help improve outcomes. Some examples:

Delaware HB346 amends state code to allow any resident to vote by mail. In explaining the need for this change, the bill cites both the vulnerability of persons over 60 and the CDC recommendation that nursing homes, long-term care facilities, and senior living facilities should not be used as polling places.

HR915 in Pennsylvania calls for the impeachment of Gov. Tom Wolf for “misbehavior in office.” One of the five articles of impeachment is that he “failed in his duty” to protect residents of nursing homes and long-term care facilities. In support of this charge, it points to March guidance from the state’s Department of Health that, according to the resolution, urged these facilities to “admit and readmit” patients who had tested positive for COVID-19.

Louisiana HCR13 highlights the challenges the pandemic has created in providing adequate care for elderly persons with dementia, a population particularly susceptible to COVID-19. It notes that almost half of residents of nursing homes suffer from dementia. Among other things, it directs the state’s Department of Health to develop protocols for testing all residents of these facilities and to maintain a Web platform that provides searchable, de-identified COVID-19 data from all long-term care facilities. It also calls for isolation and treatment protocols, and essential care standards that can help provisional staff provide appropriate treatment to patients with dementia.  

HB20-1410, a Colorado bill, calls for a portion of the $1.7 billion the state received from the Coronavirus Relief Fund to be used to support virus containment by preventing individuals and families from becoming homeless. Medicaid clients who are living in nursing homes are among the priorities for distribution of the rental assistance program outlined in the bill.  

S8461 in New York mandates that nursing home facilities in the state prominently display the most recent rating they have earned according to the inspection system of the U.S. Centers for Medicare and Medicaid Services (CMS), and that the ratings be displayed on the state Department of Health’s website. It observes that past investigations have discovered violations that could cause harm have been found in nearly one in three nursing homes, and that the CMS ratings are easily understood resources for families at times of crisis.

Vermont H966 appropriates $20 million from the Coronavirus Relief Fund to provide grants that would enable employers to give hazard pay to front-line workers placed at risk by the nature of their jobs. Employers of persons who work at assisted living facilities, nursing homes and residential care homes would be eligible for the grants.  

A4282, a New Jersey bill, requires nursing homes to maintain a supply of personal protection equipment (PPEF) for residents at all times. This would include gowns, gloves, masks, gloves or other items worn by residents of nursing homes to minimize the spread of disease. These facilities are to provide biennial reports on their PPE inventory to the Department of Health.  

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