The New York Times decided to use Labor Day weekend as its bully pulpit to bash the nursing home industry yet again in one of the longest editorials we can remember. They called it “The Shameful Toll of Nursing Homes.”
Surprisingly, there were actually some decent recommendations and even a few actual facts that we can’t dispute. But, like always, they just don’t get it when it comes to health care, money and policy.
First of all, they started with the proposition that the nation’s nursing homes “had months of warning about the coming threat.” Come again? Warning from whom? The first confirmed death “by” COVID-19 did not occur until the end of February, and most people were still not sure what it was and whether it was just an infection that was worse than the flu.
It is also important to note that the Centers for Disease Control and Prevention did not have a good grasp on the seriousness of the situation early in the spread. In a release in mid-January, the CDC said that while “originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening.” So much for “months of warning.” Even two months after this, many people thought the outbreak may have been a one-off event at the Life Care Centers facility in Kirkland, Washington. Many people attending the NIC conference in San Diego in early March thought this as well.
And of course, the NYT had to attack for-profit providers and private investment firms who “squeezed profits out of these facilities by forcing them to skimp on care” and that “staff quality has suffered” as a result. As usual, the NYT forgets that it has been hard to get qualified staff at the wages that are reimbursed by Medicaid, which funds the majority of the patients in nursing homes. Oh well, not their problem.
One statement they got partially right, and here we agree with them (partially). The editorial claims that Trump (or the industry) wants total immunity from wrongful death and other malpractice lawsuits, including those pertaining to coronavirus, from 2019 through 2024. We believe the associations and lobbyists are excluding egregious cases of wrongful death, and we believe those providers should be prosecuted to the full extent of the law.
We also disagree with going back to 2019 (what does that have to do with the coronavirus?), and through 2024 seems a little extreme (okay, a lot extreme) if a vaccine is widely available within a year. It seems like the industry is going for too much, and will look greedy at a time when it can least afford to.
The paper also made the rather outlandish statement that the “only way to prevent the coronavirus from racing through nursing homes is to nationalize the supply chain for the essential tools,” meaning PPE as well as testing. We are not sure whether they saw the irony in their own recommendation, “nationalizing” under a Trump administration. Perhaps they were just forward looking and assume Biden will win. We would be happy if the federal government would simply agree to pay for all testing. And by the way, how do you nationalize a supply chain coming from China? Hmmm.
The editorial did recommend that federal officials need to reconsider Medicaid rates for long-term care so that higher wages can be paid. But shifting some of that funding to Medicare, as they recommend, at a time when this program is already under financial strain makes little sense, especially as 10,000 baby boomers a day enroll in it, further aggravating the financial strain. Having the government provide hazard pay for nursing home workers is a reasonable idea, but for how long? Anecdotally, we have heard that some companies have stopped hazard pay as their facilities become COVID-free.
Most everything that the editorial recommends costs money, but at a time when deficits are at record levels and still climbing. But their OpEd economist is a staunch believer that deficits don’t matter. The problems are a lot more complicated than the assertion that for-profit companies and private equity are the cause of all wrongdoing in the nursing home sector. Unfortunately, they don’t even bring up the fact that too many people on Medicaid in nursing homes could and should be paying for it themselves. But then the Medicaid estate planners would cancel their subscriptions.
