Pandemic-fueled shortages of home health aides strand patients without care

Link:https://www.cnn.com/2022/02/03/health/home-health-care-aide-shortage-khn-partner-wellness/index.html

Excerpt:

Frail older adults are finding it harder than ever to get paid help amid acute staff shortages at home health agencies.

Several trends are fueling the shortages: Hospitals and other employers are hiring away home health workers with better pay and benefits. Many aides have fallen ill or been exposed to Covid-19 during the recent surge of omicron cases and must quarantine for a time. And staffers are burned out after working during the pandemic in difficult, anxiety-provoking circumstances.

The implications for older adults are dire. Some seniors who are ready for discharge are waiting in hospitals or rehabilitation centers for several days before home care services can be arranged. Some are returning home with less help than would be optimal. Some are experiencing cutbacks in services. And some simply can’t find care.

Author(s):Judith Graham, Kaiser Health News

Publication Date: 3 Feb 2022

Publication Site: CNN

Covid-19, Endemic or Not, Will Still Make Us Poorer

Link: https://www.wsj.com/articles/covid-19-endemic-or-not-will-still-make-us-poorer-11642608213

Excerpt:

Endemic Covid-19 could thus become a lasting “supply shock” that degrades how much economies can produce, similar to the surge in oil prices in the 1970s. In October, the International Monetary Fund estimated global output this year would still be 3% lower than it had projected in 2019, with Western Europe and Latin America showing much bigger hits than China and Japan, where Covid-19’s toll has been much lower.

The U.S. is an exception: Output in the last quarter of 2021 was roughly back to its pre-pandemic trend. But the economy, distorted and disrupted by Covid-19, is struggling to sustain this level of output, as the surge in inflation to 7% demonstrates.

Covid-19 might have boosted efficiency in some industries by speeding up digitization and adoption of remote work. Goldman Sachs economists estimate this delivered a 3% to 4% boost to U.S. productivity.

But some of the shift to remote operations is involuntary, and some of the rise in productivity might reflect an overworked workforce. Indeed, the pandemic has left the labor force smaller, sicker and less happy. Absences due to illness among employed workers have averaged 50% higher in the last two years. In early January, nearly 12 million people weren’t working because they were sick with Covid-19, caring for someone with coronavirus, or concerned about getting or spreading the disease, according to a regular Census Bureau survey. The figure hasn’t been below 4 million since June 2020.

In the past year, workers have reported declining satisfaction with their wages and a rising “reservation wage,” that is, how much they would have to be paid to accept a new job, according to the Federal Reserve Bank of New York. This might reflect inflation, changed expectations, or stress due to Covid-19 testing, masks and vaccine mandates, or their absence.

For employers, this makes it much harder to attract the necessary staff. Nursing homes have boosted hourly wages 14% since the start of the pandemic, yet staffing has plummeted 12%, impairing their ability to accept new patients. Such shortages impose a cost that doesn’t show up in gross domestic product.

Author(s): Greg Ip

Publication Date: 19 Jan 2022

Publication Site: WSJ

Report: Number of Michigan Nursing Home Deaths 42 Percent Larger Than Whitmer Disclosed

Link: https://freebeacon.com/democrats/report-number-of-michigan-nursing-home-deaths-42-percent-larger-than-whitmer-disclosed/

Excerpt:

The number of COVID-19 deaths in Michigan nursing homes is 42 percent larger than Democratic governor Gretchen Whitmer’s administration disclosed, according to a state auditor general’s report reviewed by the Washington Free Beacon.

The report, which Auditor General Doug Ringler is set to release in full next week, shows 8,061 COVID-19 deaths in the state’s long-term care facilities from Jan. 1, 2020, to July 2, 2021. That number is 42 percent larger than the 5,675 deaths Whitmer’s health department reported.

Author(s): Collin Anderson

Publication Date: 13 Jan 2022

Publication Site: Washington Free Beacon

COVID-19: Eight Dead, 89 Infected In Outbreak At Connecticut Nursing Home

Link:https://dailyvoice.com/new-york/northsalem/news/covid-19-eight-dead-89-infected-in-outbreak-at-connecticut-nursing-home/819985/

Excerpt:

Eight residents of a Connecticut nursing home have died during a COVID-19 outbreak that has lasted nearly six weeks.

A total of 89 employees and residents have tested positive since the outbreak began at the Geer Nursing and Rehabilitation Center, located in Litchfield County, in the Town of Canaan, on Thursday, Sept. 30.

“Despite seeing significant numbers of residents recovering from Covid,” the facility’s chief executive Kevin O’Connell and nursing director Cady Bloodgood said in a statement. “testing has resulted in one additional positive case among fully vaccinated residents and staff members. Sadly, we have lost eight residents with serious underlying health issues to Covid.”

Author(s): Joe Lombardi

Publication Date: 14 Nov 2021

Publication Site: Daily Voice

Nursing homes warn vaccine mandate could lead to staff shortages

Link: https://thehill.com/policy/healthcare/570807-nursing-homes-warn-vaccine-mandate-could-lead-to-staff-shortages

Excerpt:

The Biden administration’s vaccination requirement is putting a squeeze on nursing homes as they try to balance protecting residents and retaining low-wage staff that have been reluctant to get the shot.

Later this month, the administration will outline a policy that requires all staff working at nursing homes to be vaccinated or risk the facilities losing federal funding.

The specifics of the policy are sparse so far, but it would effectively be a mandate for an industry that relies heavily on Medicare and Medicaid funding.https://aef67baff698e02f95a8ec2b0d53753d.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

Only about 62 percent of nursing home and long term care facility staff are fully or partially vaccinated nationally, according to federal data compiled by the Centers for Medicare and Medicaid Services (CMS).

…..

“The biggest group of unvaccinated staff are certified nurse aides. They’re making close to minimum wage. They can make that, maybe even more, plus maybe even better benefits out in retail jobs, restaurant jobs. The vast majority of those employers are not imposing mandates,” Grabowski said.

Author(s): NATHANIEL WEIXEL

Publication Date: 4 September 2021

Publication Site: The Hill

Report and Recommendations of the Task Force on Nursing Homes and Long-Term Care

Link: https://nysba.org/app/uploads/2021/06/11.-Task-Force-on-Nursing-Home-and-Long-Term-Care-Report-staff-memo-and-comments-6.11.2021.pdf

Graphic:

Excerpt:

Because of the anticipated need for large numbers of hospital beds, the Governor, in his first Executive Order issued under his emergency powers, authorized hospitals to “rapidly discharge” patients47. An especially important event in terms of the State’s health care capacity occurred on March 23rd. On that date, Governor Cuomo issued an Executive Order requiring that all hospitals cancel elective surgeries to free up hospital beds, and urged that hospitals go beyond the order and increase their capacity by 100%. Health officials said that day that New York had 53,000 hospital
beds with an anticipated need due to COVID-19 of 113,000. Officials also stated that New York had 3,000 ICU beds with an anticipated need due to COVID-19 of 18,000.


Two days later, on March 25th, the Department of Health issued the now infamous Advisory to nursing homes. The Advisory was explicitly issued out of concern for hospital capacity. It said so in its second sentence. “There is an urgent need to expand hospital capacity in New York State to be able to meet the demand for patients
with COVID-19 requiring acute care.” The Advisory went on to state the expectations for nursing homes.

Author(s): New York State Bar Association Task Force on COVID-19 in New York Nursing Homes and Long-Term Care

Publication Date: June 2021

Publication Site: New York State Bar Association

Cuomo Aides Spent Months Hiding Nursing Home Death Toll

Link: https://www.nytimes.com/2021/04/28/nyregion/cuomo-aides-nursing-home-deaths.html?smid=tw-share

Excerpt:

Aides to the New York governor, Andrew M. Cuomo, repeatedly prevented state health officials from releasing the number of nursing home deaths in the pandemic.

The effort by Gov. Andrew M. Cuomo’s office to obscure the pandemic death toll in New York nursing homes was far greater than previously known, with aides repeatedly overruling state health officials over a span of at least five months, according to interviews and newly unearthed documents.

Mr. Cuomo’s most senior aides engaged in a sustained effort to prevent the state’s own health officials, including the commissioner, Howard Zucker, from releasing the true death toll to the public or sharing it with state lawmakers, these interviews and documents showed.

A scientific paper, which incorporated the data, was never published. An audit of the numbers by a top Cuomo aide was finished months before it became publicly known. Two letters, drafted by the Health Department and meant for state legislators, were never sent.

….

The Cuomo administration’s handling of nursing home death data now is the subject of a federal investigation, one of at least four overlapping inquiries into the governor and his administration. As of this month, more than 15,500 nursing home residents with Covid-19 have died.

Author(s): Goodman, J David; Mckinley, Jesse; Hakim, Danny.

Publication Date: 28 April 2021

Publication Site: New York Times

Measuring the COVID-19 Policy Response Around the World

Link: https://freopp.org/measuring-the-covid-19-policy-response-around-the-world-2e37a7a97bc8

Graphic:

Excerpt:

In the U.S., 38% of all deaths from COVID-19 have occurred in nursing homes and assisted living facilities that house only 0.6% of the U.S. population. The failure to protect this population is not only a problem in the U.S., however; a survey of international countries found similar results.

Indeed, among 22 countries reporting care home fatalities, the U.S. sits squarely in the middle in terms of the share of fatalities occurring in care homes. Among WIHI countries, Canada (80%) and Australia (75%) had the highest concentration of fatalities in nursing homes, whereas Singapore (11%) and Hungary (23%) the lowest.

While Ireland reported a care home fatality share of 56%, its true share is closer to Canada’s, because Ireland, Finland, New Zealand, and Norway do not report deaths of care home residents who die outside of long-term care facilities. In other countries, roughly one-quarter of COVID-19 deaths of care home residents occur in hospitals and other external locations.

Author(s): Avik Roy

Publication Date: 5 April 2021

Publication Site: FREOPP

Mortality with Meep: Location of Death Data for 1999-2020, Entire United States

Link: https://marypatcampbell.substack.com/p/mortality-with-meep-looking-at-location

Graphic:

Excerpt:

For a few locations, it’s pretty clear that COVID explains almost all their excess deaths: inpatient healthcare facilities and nursing homes. Indeed, it looks like over 100% of the nursing home excess mortality came from COVID, which accords with what I see with excess mortality for older people.

However, there is a lot of excess mortality for people who died at home, and most of that is currently unexplained by COVID.

I don’t think it will be — I think we will find those excess diabetes, heart attack, and ‘unintentional injury’ deaths will have been at home, and because of lockdowns there weren’t other people around to get these people to treatment before they died. This accords with what Emma Woodhouse saw for Illinois – that pattern holds for the entire U.S., it seems.

Author(s): Mary Pat Campbell

Publication Date: 20 April 2021

Publication Site: STUMP at substack

Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

Link: https://www.nytimes.com/2021/03/13/business/nursing-homes-ratings-medicare-covid.html

Excerpt:

Much of the information submitted to C.M.S. is wrong. Almost always, that incorrect information makes the homes seem cleaner and safer than they are.

Some nursing homes inflate their staffing levels by, for example, including employees who are on vacation. The number of patients on dangerous antipsychotic medications is frequently understated. Residents’ accidents and health problems often go unreported.

In one sign of the problems with the self-reported data, nursing homes that earn five stars for their quality of care are nearly as likely to flunk in-person inspections as to ace them. But the government rarely audits the nursing homes’ data.

Data suggest that at least some nursing homes know in advance about what are supposed to be surprise inspections. Health inspectors still routinely found problems with abuse and neglect at five-star facilities, yet they rarely deemed the infractions serious enough to merit lower ratings.

At homes whose five stars masked serious problems, residents developed bed sores so severe that their bones were exposed. Others lost the ability to move.

Author(s): Silver-Greenberg, Jessica; Gebeloff, Robert.

Publication Date: 13 March 2021

Publication Site: New York Times

F.B.I. Investigating Whether Cuomo Aides Gave False Data on Nursing Homes

Link: https://www.nytimes.com/2021/03/19/nyregion/cuomo-nursing-homes-covid.html

Excerpt:

The state revealed the full count — which added thousands of additional deaths — only in January, after a report by the state attorney general suggested an undercount, and after a state court ordered the data be made public in response to a lawsuit filed by the Empire Center, a conservative think tank. As of this month, New York has recorded the deaths of more than 15,000 nursing home residents with Covid-19.

Melissa DeRosa, Mr. Cuomo’s top aide, tried to explain why the administration had withheld the data last year to state lawmakers in a conference call, saying she and others “froze” because of the federal request for data, which came in late August as the governor faced criticism over nursing homes.

But more than two months earlier, in June, Ms. DeRosa and other aides removed such data from a report prepared by the Health Department, an investigation by The New York Times found.

Author(s): J. David Goodman, Nicole Hong and Luis Ferré-Sadurní

Publication Date: 19 March 2021

Publication Site: New York Times