Pandemic lessons evident in nursing home proposal

Boston Statehouse

Nursing Homes Continue To Fight Against the Coronavirus

BOSTON (State House News Service) – Care for seniors in nursing homes and across the entire continuum of services should be improved, and the COVID-19 pandemic could serve as an impetus for that change, the Senate chair of the Elder Affairs Committee said Monday.

“We have to build up assisted livings, supportive housing, home care and support for family caregivers, and change the funding — increase the funding — for all of them, and make it possible for people to get care in the community,” Sen. Pat Jehlen said at a virtual AARP Massachusetts advocacy day.

Jehlen, a Somerville Democrat, grew emotional as she urged advocates to remember “how we felt in May, in March, last year” as the first COVID-19 surge tore through nursing homes.

“I was talking to nursing home administrators who were in tears because they had three nursing assistants trying to feed 12 people who couldn’t feed themselves, because we had people who weren’t getting fed because there weren’t enough staff to bring their meals to their rooms,” Jehlen recalled. “Daughters were calling me because they couldn’t reach their parents. One woman had her mother, who didn’t speak English and had no one to talk to and was having invasive things happen to her like COVID tests, and she didn’t know what was going on. She had no one to talk to.”

Jehlen and Newton Rep. Ruth Balser talked to lobby day participants about their bill (S 414, H 727) that proposes new requirements for nursing homes, with the goal of improving the quality of care.

The bill includes provisions that would increase the minimum number of hours of care per resident per day from 3.5 to 4.1, require nursing facilities to have outbreak response plans, develop a pathway to single-occupancy rooms, and increase staff training through career ladder programs.

Balser and Jehlen said the bill would also require long-term care facilities to adopt policies to prevent residents’ social isolation, including through the use of technology.

Visitor restrictions instituted earlier in the pandemic were “terribly painful” for long-term care residents, Balser said.

“Some people tragically died alone. Those who survived suffered just from the isolation, and so this bill is really a wonderful attempt to honor the memories of those we lost by trying to reform the nursing home industry and to make nursing homes a better place for people to age,” she said.

Financial challenges, facility closures and worker shortages put nursing homes on policymakers’ radars before COVID-19 took hold in Massachusetts and brought with it new burdens for the facilities, their staff and residents.

In February 2020, the same month the state’s first confirmed case of the coronavirus was identified, a nursing home task force whose membership included Jehlen and Balser released a report that articulated four policy goals: adjusting the industry size “in response to current and future demand,” reforming the rate structure, promoting high-quality care, and ensuring a sustainable workforce.

A $3.82 billion spending package the House passed last week allocating both American Rescue Plan Act funds and surplus tax dollars from fiscal 2021 included $70 million for nursing facilities.

In September, the Massachusetts Senior Care Association outlined how it wanted to see the state spend its surplus revenues and federal relief dollars. The association asked for a one-time $98 million investment for the 22,000 nursing home residents whose care is paid for by MassHealth, along with another one-time investment of $461 million over three years to finance a nursing facility workforce fund, a quality care and resident experience fund, and an infrastructure fund.

Association President Tara Gregorio said in a Sept. 21 statement that nursing facilities in Massachusetts were facing an “urgent and immediate need to hire and retain direct care workers.” She said “increasing financial instability” had led to 11 recent closures and projected that more than 100 facilities were “at risk of closure in the next 12 months.”

Senate leaders are expected to detail their plans for an ARPA bill this week.

Speaker Ron Mariano told the AARP that, in addition to the nursing home money, the House spending bill also contains $150 million towards the production of permanent supportive housing “for our most vulnerable populations, including seniors.”

“These much-needed funds will create more affordable housing and offer wraparound services to those who live there,” he said. “It is so important that we support our seniors and caregivers as we continue to navigate our way through the COVID-19 pandemic.”

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