Trump Administration Proactively Warned States on COVID-19 Nursing Homes Crisis

U.S. Republican presidential candidate Trump makes a point as he formally announces his campaign for the 2016 Republican presidential nomination at Trump Tower in New York
President Donald Trump

President Donald Trump‘s administration has been warning states in a number of memorandums since as early as Feb. 6 to prepare the nation’s nursing homes for the COVID-19 threat, KCP has learned.

But despite the numerous warnings and memorandums from the Trump administration to be better prepared, scores of people in nursing homes have died around the borough, leaving the dead in the facilities for days, families unnotified and nursing homes workers complaining of not having personal protective equipment (PPE).

The documented proof of Trump administration and warnings and declarations was presented yesterday following the Centers for Medicare & Medicaid Services (CMS) announcement of new regulatory requirements that will require nursing homes to inform residents, their families and representatives of COVID-19 cases in their facilities.

In addition, as part of Trump’s Opening Up America, CMS will now require nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).

Photo by Ariama Long

This information must be reported in accordance with existing privacy regulations and statute. This measure augments longstanding requirements for reporting infectious disease to State and local health departments. Finally, CMS will also require nursing homes to fully cooperate with CDC surveillance efforts around COVID-19 spread.

“Nursing homes have been ground zero for COVID-19. Today’s action supports CMS’ longstanding commitment to providing transparent and timely information to residents and their families,” said CMS Administrator Seema Verma. “Nursing home reporting to the CDC is a critical component of the go-forward national COVID-19 surveillance system and to efforts to reopen America.”

The CMS first memorandum issued on February 6, warned healthcare facilities to the threat of the 2019-Novel Coronavirus and advised health care providers and State Survey Agencies (SAs), the entities that inspect healthcare facilities, including nursing homes, to ensure compliance with current CMS requirements and safety standards.

Then on March 4, CMS issued new guidance related to the screening of entrants into nursing homes, informed by CDC recommendations. On March 10, CMS issued guidance related to the use of personal protective equipment (PPE) usage and optimization. On March 13, CMS issued guidance for a nationwide restriction on nonessential medical staff and all visitors, except in compassionate care situations.

Shortly after that announcement, Trump declared a national emergency, enabling the agency to take even stronger action. CMS then announced a suspension of routine inspections, and an exclusive focus on situations in which residents are in immediate jeopardy for serious injury or death, and implemented a new inspection tool based on the latest guidance from CDC.

Additionally, on April 2, CMS issued a call to action for nursing homes and state and local governments. It included guidance that reinforced infection control responsibilities and urged leaders to work closely with nursing homes in their communities to determine needs for COVID-19 testing and personal protective equipment.

The recommendations also urged state and local officials to work with nursing homes to designate certain sites for COVID-19-positive or COVID-19-negative patients to avoid further transmissions.

Nursing homes are under the regulatory jurisdiction of the state Department of Health (DOH) and not the city. Thus far the state’s only action to address the situation was Gov. Andrew Cuomo issuing an executive order last week requiring nursing homes to report positive COVID-19 cases and deaths to the families of those who are living in the nursing home facility within 24 hours.

Previously, the DOH issued guidance asking these facilities to communicate this information to families; this new order makes that guidance mandatory.

Despite the multiple Trump Administration memorandums, media outlets have been reporting the tragic amount of deaths at Brooklyn nursing homes starting with the KCP exclusive of eight bodies being left for days at the Crown Heights Center for Nursing and Rehabilitation.

The hardest-hit nursing facility thus far during the pandemic has been the Cobble Hill Health Center where 55 patients have died followed by 34 dead at the Bensonhurst Center for Rehabilitation in Brooklyn.

As of last Friday evening, 3,316 elderly nursing resident residents died at either nursing homes, adult day care facilities or hospitals from COVID-19. Of that total, the virus killed 2,056 nursing residents in New York City.