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Who Will Be Held Accountable?

Published on April 30th, 2020

Government records into nursing homes reveal how supply shortages, lapses in care, short-staffing, a lack of transparency and inadequate training related to infection control precautions are fueling the spread of Covid-19 within America’s nursing homes. Facilities have been struggling for years. Now already burnt-out and overwhelmed workers are trying to identify, isolate and treat patients with the disease on top of their already demanding jobs. Measures aimed at protecting residents from the spread of the disease, meanwhile, have left them even more vulnerable and closed off from the public. As a result, elder advocates, health care experts, and government watchdogs say it is becoming easier for abuse and neglect to go unchecked and to cove-up incidents of criminal behavior. State long-term care ombudsmen, who are tasked with protecting residents, told CNN there are not enough eyes on these facilities at a time when oversight is needed the most.

Many of the country’s nursing homes were already understaffed and frequently cited for lax infection control before coronavirus began to spread. Now staff are risking their own health and often lacking access to the supplies and testing they need as they care for a population at high risk of dying from the disease. Advocates for long-term care residents said there is a short-term financial incentive to downplay infections since a publicized outbreak could result in families removing their loved ones and hurt future business. An outbreak could also open the doors for inspectors to cite a facility for numerous other violations such as understaffing.

“There are no tests,” a nurse at a Michigan facility told a state health department employee at the end of March, according to a government report, recounting how they were expected to take care of a unit full of pneumonia patients known as the “Covid unit” and had brought their own medical supplies for residents. “I have one (resident) who is actively dying right now.”
A CNN review of more than 100 inspection reports documenting visits still taking place, and complaint information gathered from state ombudsmen, provides a snapshot of serious problems during this pandemic — including unacceptable care and failures to take steps to stem spreading infections. An analysis of the limited nursing home inspections that have occurred nationwide since last month shows failures in care may have caused Covid-19 to spread to both staff and employees. The reports detail supply shortages, failures to report Covid-19 infections and exposure to authorities, nurses not adequately monitoring potential symptoms of the disease and staff not properly wearing masks.  In addition to the many reports of understaffing, PPE shortages and a lack of transparency, state ombudsman offices told CNN they have received complaints about patients being unfairly evicted and concerns from nursing home employees who have reported being worried they will be punished for speaking out about problems.  We need to do everything we can to protect these whistle-blowers.
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