The December AARP Bulletin featured the front-page headline “An American Tragedy,” informing us that “…in just nine months, more Americans have died in nursing homes of covid-19 than were lost in the Vietnam and Korean wars combined.” The Cost of Inaction: 11 Deaths Per Hour, a study published by the U.S. Senate in September, found that during July and August, on average, more than one nursing home resident was infected every minute, and 11 residents died every hour.
In early December The Washington Post featured a front-page article titled “Do People Understand What’s Happening Here?” a first-person account of a man quarantined since March in a nursing home in Ohio. He said, “It’s boredom and then dread. They stopped allowing visitors in March, so we lost that contact with the outside world. Then it was no more group meals in the cafeteria — just eat everything alone in your room.”
The nursing home industry claims that covid-19 cases in nursing homes are inevitable if outbreaks occur in the community and, that once introduced in a facility, covid-19 will spread. These theories are not always borne out. Rather, if staffing levels are adequate, if infection control measures are implemented throughout the building, if adequate testing is done, and if adequate supplies and personal protective equipment are on hand, covid-19 can and will be contained.
The Washington Post ran a startling close-to-home front-page story in its Sunday, December 27, 2020, paper calling out Peak Health Care of Chestertown, among others, for its unsafe practices. Reporters discovered that one company, the Portopiccolo Group, has recently bought over 70 long-term care facilities, including the Chestertown site. That company describes itself on its web site as “a family-run investment company originally focused on healthcare services… as well as other strategic real estate and business investment opportunities.” Analysis by Post journalists showed that 70 percent of health care facilities owned by Portopiccolo before the pandemic had a Medicare rating of one or two stars out of five. The writers focused on Chestertown, interviewing workers at the facility as well as the Kent County Health Officer. Some very disturbing findings:
The article concluded that there is little or no government oversight of nursing home purchases. This company is continuing to acquire, and ultimately weaken, long-term care facilities.
Inadequate staffing is an omnipresent problem. In December there was an ad for cleaning staff at the Resorts at Chestertown. The pay was posted as $11.00 per hour (though effective January 1, 2021 Maryland’s minimum wage is increased to $11.75 per hour). A physically demanding, unappealing job for a pitiful wage, even without considering the covid-19 risk.
Now that the vaccine is being distributed, there is great hope that there will be fewer and fewer cases and the alarms will end. But following this dreadful experience with covid-19 in long-term care facilities (where 40 percent of all covid-19 deaths have occurred), major changes need to be made in the way we treat our frailest friends and family members.
Attorneys for AARP, Justice in Aging, and others have proposed changes in laws that emphasize better oversight, accountability, and more and better-equipped staff. Kate Ricks, Vice-chair of the non-profit organization Voices for Quality Care, thinks that it is time to consider whether long-term care should cease to be a profit-making endeavor. (According to the CDC, 69 percent are for-profit.) That question leads to the debate about the ultimate costs and benefits of our for-profit health care system.
We will see a silver lining in this pandemic, if, due to the national attention, systemic changes are made in long-term care. Let’s see some moral outrage and leadership to act.
Muriel Cole is Co-Chair of the Kent County Commission on Aging and was, for ten years, a volunteer long-term care ombudsman for Upper Shore Aging, Inc.
Title image: Pond at Pickering Creek Audubon Center, Talbot Co. Photo: Jan Plotczyk