Casey, Wyden push for nursing home data

Nursing homes nationwide must now report COVID-19 cases and deaths and some other pandemic-related information to the federal government, and that information will be made public in a few weeks, but that's not nearly soon enough to suit some elected officials.

U.S. Sens. Bob Casey, D-Pennsylvania, and Ron Wyden, D-Oregon, on Friday accused President Donald Trump's administration of slow-walking the release of the information.

"The Centers for Medicare & Medicaid Services continues to delay the collection and dissemination of data regarding the rapid and tragic spread of COVID-19 in nursing homes across the nation," the senators said in a press release.

In a separate statement, Casey pounded the Trump Administration for mismanaging a crisis he said has harmed seniors in nursing homes.

"The lack of transparency into where the virus has spread not only delays our response to this crisis, it unnecessarily risks lives. Thus far, the Administration has taken baby steps towards what's needed, without knowing where to address their response. Without this information, adequate testing and a full supply of (personal protective equipment), our seniors will continue to suffer," Casey said.

In response, CMS provided a statement saying that "in the absence of congressional action, the Trump Administration made historic efforts to increase nursing home transparency requirements to ensure residents, families and the public have critical information on (COVID-19) cases in their community's nursing homes."

CMS noted the agency alerted nursing homes on April 19 that new reporting requirements would be coming, and was committed to following timelines CMS laid out in an Interim Final Rule released April 30.

With the new requirements implemented by CMS over three weeks from the initial notice to nursing homes, nursing homes are now required to report the first week of data to the Centers for Disease Control and Prevention beginning May 8 but no later than May 17, the agency noted.

"Our guidance clearly states that we plan to publicly release this data by the end of May. Given this, it is unclear to us the basis of the senators' criticism," CMS said.

Moving too slowly

Casey and Wyden sent a letter on April 2 to CMS Administrator Seema Verma and CDC Director Robert Redfield urging the agencies to collect and release information on the incidence of COVID-19 and related deaths at individual nursing homes and to make the information available to the public.

The senators sent the letter after the CDC reported earlier that week that 400 nursing home residents had died due to COVID-19. That number has since climbed to more than 20,000, according to a recent report by The Associated Press.

CMS, which regulates more than 15,000 nursing homes nationwide, released on Wednesday a guidance memo detailing nursing home reporting requirements under the rule.

The guidance document made clear that it will be several weeks, if not longer, until COVID-19 cases and deaths at nursing homes are reported to residents, their families, and the public, according to Casey and Wyden.

The senators' major complaints are:

--Slow implementation: CMS will not require nursing homes to begin to submit data to CDC until May 17, and the agency is giving nursing homes an additional three-week grace period to comply. Nursing homes that fail to report the data will not face monetary penalties until after June 7.

--Slow public reporting: CMS does not anticipate that it will begin publicly reporting the data nursing homes submit until late May -- nearly three months after the first COVID-19 death at a nursing home in Washington state, and nearly two months after Casey and Wyden first requested that CMS and CDC publicly report nursing home COVID-19 information.

--Relaxed reporting rules: According to a memo CMS issued on April 19, nursing homes will be allowed to wait up to 41 hours before reporting new COVID-19 cases to residents and their families or representatives -- a significant rollback from earlier in April when the agency said it planned to require nursing homes to make these notifications within 12 hours.

Release of state data

On Wednesday, Pennsylvania Secretary of Health Dr. Rachel Levine said officials had been discussing the release of COVID-19 case and death information for individual nursing homes and that she expected there would be a decision this week.

However, Department of Health Press Secretary Nate Wardle said on Friday that officials were "continuing to consider" whether or not to release that information. "If we are to do so, it will be made available on our website," he said.

State Sen. John Yudichak, I-14, Swoyersville, commended Casey and Wyden for pushing for the release of the data and agreed it's been too slow in coming.

Yudichak also said the DOH should have been releasing that data publicly since the first cases were reported, noting that 38 other states, including New York, New Jersey and Ohio, are doing so. He said the DOH has been "hiding behind" the 1955 state Disease Prevention and Control Act, which limits the release of communicable disease data.

"Under the emergency declaration (Gov. Tom Wolf) made on March 6, the secretary has the authority under terms of the emergency to supersede that Act," he said. "This information is important to not only residents, their families and the public, but also to emergency responders."

No comprehensive plan

Yudichak also slammed the Wolf Administration and the DOH for having "no comprehensive, statewide action plans for nursing homes in Pennsylvania."

He said West Virginia and Wisconsin are providing comprehensive COVID-19 testing for all nursing home residents and employees.

Yudichak noted that Levine testified before the state Senate Aging and Youth and Health and Human Services committees earlier this week that the state has the capacity for comprehensive testing at nursing homes and are considering implementing it, but currently has no plan set up.

And, while Massachusetts is cohorting nursing home residents who tested positive for COVID-19 to separate facilities in order to lessen the chance of spreading the virus, the DOH is recommending that residents hospitalized with COVID-19 return to the nursing homes to recover -- a move intended to keep hospital beds free for serious cases.

Yudichak said he would like to know why underutilized field hospitals set up to handle COVID-19 patient overflow from hospitals can't be used to house nursing home residents, which would be allowed under CMS rules.

And despite claims from the Trump Administration earlier this week that personal protective equipment is being adequately supplied to nursing homes, Yudichak is concerned that they are "still short of supplies and resources."

Yudichak announced last week the establishment of the Northeastern Pennsylvania Nursing Home Supply Operate Save Program to assist area nursing homes with an initial $250,000 donation from Earth Conservancy and a matching grant from the AllOne Foundation, but he's concerned that aid still won't be adequate.

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