Coronavirus crisis in nursing homes requires aggressive federal response, White House-convened panel says

The Centers for Medicare and Medicaid Services has the panel's draft list of recommendations

The nation’s nursing homes need an aggressive and comprehensive federal approach to the COVID-19 crisis, including supplying facilities with personal protective gear, assisting with staffing shortages and offering coronavirus testing with rapid results, according to recommendations from a commission convened by the Trump administration.

The commission is due to deliver its final report Sept. 1, but it has already provided slides with a draft list of recommendations to the Centers for Medicare and Medicaid Services, the agency that spearheaded the panel’s formation, according to people with knowledge of the matter.

The recommendations could change before the final report emerges, according to the people.

The commission is suggesting that the federal government should ensure that all nursing homes get three months’ worth of protective gear, and that it create a national strategy to guarantee access to rapid-results testing for all nursing homes, according to the people with knowledge of the matter.

The commission is also recommending that the federal government help nursing homes address staffing issues, with one option including providing funds for hazard pay, the people said.

The coronavirus is cutting a deadly swath through senior-care facilities, with more than 70,000 deaths so far, according to a Wall Street Journal tally of state and federal data. Deaths in long-term care facilities account for at least 40% of all U.S. deaths tied to the virus.

After COVID-19 cases in nursing homes appeared to dip in June, there was a resurgence, particularly in some states where infections are rising among their broader populations. Nationally, the number of new cases in the week ended June 28 was 7,569, rising to 11,478 in the week ended July 26, and falling to 9,728 in the most recent week available, ending Aug. 9, according to a Wall Street Journal analysis of CMS’s most recent weekly data.

The Journal’s analysis of the federal data included only nursing homes that reported data that consistently cleared the government’s data-quality checks and excluded some additional nursing homes that reported more COVID-19-linked deaths than total deaths in any week. CMS sometimes retroactively updates prior data in its new releases.

The Trump administration launched the commission, formally called the Coronavirus Commission on Safety and Quality in Nursing Homes, “to independently and comprehensively assess the response to the COVID-19 pandemic and offer actionable recommendations to inform future responses to infectious disease outbreaks within nursing homes,” a spokesman for CMS said.

He also said that while the agency has “received some preliminary information from the commission,” CMS Administrator Seema Verma has “not seen or been briefed on any recommendations at this time because the commission’s work is still in progress, and to protect the integrity of the process she will not be briefed until CMS receives the commission’s final recommendation.”

The draft recommendations echo months of calls from nursing-home industry officials and outside researchers for the federal government to take more action to help stem the effects of COVID-19 in nursing homes.

“The federal government needs a more coordinated response to the outbreak in nursing homes,” said Hye-Young Jung, assistant professor of health-care policy and research at Weill Cornell Medical College, who isn’t on the commission. “It’s more testing, more [personal protective equipment], more resources.”

The commission is overseen by Mitre Corp., an outside contractor that works frequently with the federal government. Its membership, announced in June, includes nursing-home industry officials, academic researchers and consumer advocates, who were asked to sign nondisclosure agreements about the group’s workings. Its meetings weren’t open to the public.


Members agreed to keep information confidential “to facilitate candid sharing of these views and encourage robust debate,” Mitre said in June. Mitre referred questions about “public release of the recommendations” to CMS.

The Trump administration previously promised two weeks’ worth of protective gear to nursing homes, but some facilities said the material they received was unusable. The administration has said it is focused closely on nursing homes, and officials announced in July that the facilities would get an additional $5 billion in funding from the previously passed coronavirus stimulus package.

The Department of Health and Human Services is sending rapid-testing platforms to nursing homes, and 3,594 facilities were supposed to have received the equipment by the end of this week, according to Adm. Brett Giroir, the Trump administration’s testing coordinator. He said Wednesday that the federal government aims to get testing equipment to eligible nursing homes by the end of September.

But the equipment is set to come with a limited number of testing kits, and nursing homes have struggled to order refills, nursing-home companies said. Adm. Giroir said that “everybody is going to be tight on tests through August and September.”