Trump Said He Was Not Going To Cut Entitlements Like Every Other Republican. According to the Daily Signal, “Donald Trump says if he runs for president he’ll make sure entitlement programs aren’t touched. ‘I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,’ Trump told The Daily Signal. ‘Every other Republican is going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do.’” [Daily Signal, 5/21/15]
VIDEO: Trump Said, “I’m Not Going To Cut Social Security Like Every Other Republican.” According to the Daily Signal via YouTube, “TRUMP: I’m not going to cut Social Security like every other Republican. And I’m not going to cut Medicare or Medicaid. [Daily Signal via YouTube, 5/21/15]
VIDEO: Trump Said He Would Not Cut Medicare Or Medicaid. According to the Daily Signal via YouTube, “TRUMP: I’m not going to cut Social Security like every other Republican. And I’m not going to cut Medicare or Medicaid.” [Daily Signal via YouTube, 5/21/15]
Trump Said He Was Going To Save Social Security Without Any Cuts. According to Donald Trump via his post on Twitter, “I am going to save Social Security without any cuts. I know where to get the money from. Nobody else does."
[Twitter, @realdonaldtrump, 5/21/15]
Trump Said He Was The First And Only GOP Candidate To State There Would Be No Cuts To Social Security, Medicare Or Medicaid. According to Donald Trump via his post on Twitter, “I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid. Huckabee copied me.” [Twitter, @realdonaldtrump, 5/7/15]
March 5, 2020: At Fox News Townhall, Trump Stated That, “Oh, We’ll Be Cutting” Entitlements. According to the Week, “And so at a Fox News town hall in Scranton, Pennsylvania, on Thursday, Martha McCallum argued that ‘if you don't cut something in entitlements, you'll never really deal with the debt.’ ‘Oh, we'll be cutting,’ Trump said, but he also promised that, presumably in a second term, the U.S. will see ‘growth like you never had before.’” [The Week, 3/6/20]
VIDEO: Trump On Entitlements: “Oh, We’ll Be Cutting.” According to Fox News via Twitter, “HOST: If you don’t cut something in entitlements, you’ll never really deal with the debt. TRUMP: Oh, we’ll be cutting.” [Fox News via Twitter, 3/5/20]
January 22, 2020: Trump Stated That “At Some Point” Entitlements Cuts Would Be On The Table. According to CNN, “President Donald Trump signaled this week that he's open to cutting federal entitlements to reduce the federal deficit, despite previously campaigning on protecting Medicare and Social Security. Asked by CNBC at the World Economic Forum in Davos, Switzerland, whether entitlements would ever be on his plate, Trump responded, ‘At some point they will be.’ ‘We have tremendous growth. We're going to have tremendous growth. This next year I -- it'll be toward the end of the year. The growth is going to be incredible. And at the right time, we will take a look at that,’ he added.” [CNN, 1/23/20]
VIDEO: Trump Said That Entitlement Cuts Would Be On The Table “At Some Point.” According to CNBC via Twitter, “HOST: Will entitlements ever be on your plate? TRUMP: At some point they will be.” [CNBC via Twitter, 1/22/20]
Trump FY 2021 Budget Cut $500 Billion From Medicare Over 10 Years. According to the Center on Budget Policy Priorities, “President Trump’s 2021 budget proposes about $500 billion in net Medicare spending reductions over ten years (see table), most of which would come from reducing payments to health care providers and not affect beneficiaries directly.” [Center on Budget Policy Priorities 2/13/20]
CBPP: Budget Proposed Medicare Spending Cut $756 Billion Over 10 Years, But Cuts Reduce To $501 Billion After “Accounting For The General Revenue Payments For GME And Uncompensated Care.” According to the Center on Budget Policy Priorities, “In two cases — payments to hospitals for graduate medical education (GME) and for uncompensated care — the budget proposes to move spending from Medicare’s trust funds to new, smaller grant programs funded by general revenues. While the budget would cut Medicare spending by $756 billion over ten years, the cuts amount to $501 billion after accounting for the general revenue payments for GME and uncompensated care.” [Center on Budget Policy Priorities , 2/13/20]
Trump’s Budget Proposed Cutting Medicare Reimbursement Rates, Which Could Lead To Some Seniors Losing Access To Their Favorite Doctors. According to Forbes, “Other proposals would cut down on reimbursement rates to healthcare providers, reducing how much doctors, hospitals, and hospices are paid for providing healthcare. Cutting Medicare reimbursement rates is a controversial strategy; in the past, it’s received both support and criticism from Democrats and Republican alike […] But cutting reimbursement rates also means that some seniors could lose access to their favorite doctors. Dan Adcock, director of government relations at the National Committee to Preserve Social Security and Medicare, said of the cuts to Medicare, he was most worried about the lower reimbursement rates. When reimbursement rates decrease, ‘you start to affect access, because doctors decide they can't make a decent living,’ said Adcock.” [Forbes, 2/10/20]
Trump FY 2021 Budget Cut Medicaid By About $920 Billion Over 10 Years
Trump FY2021 Budget Cut Medicaid By About $920 Billion Over 10 Years. According to the Washington Post, “The budget cuts Medicaid spending by about $920 billion over 10 years, a change Democrats and administration critics warn would lead to reductions in benefits and the number of people on the health care program.” [Washington Post, 2/10/20]
Trump’s Budget Called For An Over $75 Billion Decrease In Spending On The Two Federal Disability Programs, SSDI And SSI, Over 10 Years. According to Forbes, “Trump’s budget calls for a $75 billion decrease to spending on the two federal disability programs, SSDI and SSI, over the next ten years. $10 billion of this reduction comes from reducing the amount of retroactive benefits someone can receive after they’ve been found to be disabled […] But Trump also promises to make other cuts to SSDI without explaining where he’ll find the money. 60% of the spending reduction from federal disability programs — $47 billion over the next ten years — come from a proposal that the Office of Management and Budget says is to ‘test new approaches to labor force participation.’ As Romig explains, the White House is hoping that by spending $100 million per year over the next five years on experimenting, they’ll come up with a ‘magical policy’ that reduces the number of people on disability programs by 5%. ‘But they don’t explain how they’ll do it,’ said Romig.” [Forbes, 2/10/20]
CBPP: Americans Between The Ages Of 60 And 66 Were 14 Times More Likely To Be On The SSDI Rolls Than Americans Between The Ages Of 30 And 34. According to Forbes. “As I’ve written previously, disabilities often emerge during middle age or late-in-life, after decades of (and sometimes as a direct result of) hard work. As a result, SSDI is especially important for seniors nearing the full retirement age of 67. According to data from the Center on Budget and Policy Priorities, Americans between the ages of 60 and 66 are 14 times as likely to currently be on the SSDI rolls as Americans between the ages of 30 and 34.” [Forbes, 2/10/20]
Like Previous Budgets Proposed By Trump, His 2021 Budget Recommended Eliminating Several Federal Grant Programs That Help Low-Income Seniors, Including Meals On Wheels. According to Forbes, “Like previous budgets proposed by Trump, his 2021 budget recommends the elimination of several federal grant programs, including the Community Development Block Grant, which is used to partially fund Meals on Wheels. And the budget proposes the elimination of the Low Income Home Energy Assistance Program, which helps low-income people, especially seniors, keep their heat on in the winter. The budget would also eliminate funding for the Senior Community Service Employment Program, which helps seniors who can’t afford to live on Social Security alone find part-time work.” [Forbes, 2/10/20]
Trump’s 2021 Proposal Would Eliminate Funding For The Legal Services Corporation, Which Provided Attorneys For Low-Income Seniors. According to Forbes, “And like previous Trump budgets, the 2021 proposal would eliminate funding for the Legal Services Corporation. Legal Services funding is used to provide attorneys for low-income seniors facing civil legal issues, including foreclosure, eviction, elder abuse, and estate planning. Other than private donations, LSC funding is the main source of civil legal assistance for seniors” [Forbes, 2/10/20]
Coalition Against Surprise Medical Billing: Americans Make About 137 Million Emergency Room Visits Per Year. “At Least 1 In 6 Patients” With Health Insurance Will Receive A Surprise Medical Bill. According to the Coalition Against Surprise Medical Billing, “Surprise medical billing can break the bank for hardworking Americans with bills totaling thousands of dollars – often in cases where patients were not able to choose their doctor. For example, every year, Americans make about 137 million visits to emergency rooms in the United States. At least 1 in 6 patients who have health insurance will receive a surprise medical bill from a provider or specialist who treated them. Importantly, not all doctors or local hospitals are the culprits behind surprise medical bills. The real issue is when clinical specialists or providers choose not to participate in health insurance providers’ networks – or if they do not meet the standards for inclusion in a network – and can then demand a blank check from patients for their services. These specialty providers are likely to charge substantially more than their peers in other specialties, not accept private insurance, and are not actively chosen by patients. Studies have found that surprise medical bills are most likely to come from emergency medicine physicians, anesthesiologists, radiologists, and pathologists.” [Coalition Against Surprise Medical Billing, 1/28/20]
2019: Trump Said He Would Send Congress A Set Of Principles That Aimed To End Surprise Medical Billing. According to CNN, “The President announced on Thursday that he’s sending a set of principles to Congress that aims to end patients’ responsibility for big charges when they unknowingly are treated by out-of-network doctors or hospitals, often in an emergency situation. ‘In emergency care situations, patients should never have to bear the burden of out-of-network costs they didn’t agree to pay,’ Trump said at press conference Thursday, standing with a family that was billed nearly $18,000 for a urine drug test that would have carried an in-network charge of just $101. ‘No family should be blindsided by outrageous medical bills.’ Half of Americans say shielding people from surprise medical bills should be a top priority for Congress, according to an April Kaiser Family Foundation poll. That ranks behind lowering drug costs and protecting those with preexisting conditions, but ahead of major changes to the nation’s health care system, such as repealing the Affordable Care Act or implementing a national ‘Medicare for All’ plan. The goal is to make sure that consumers who go to an emergency room would only pay what they would if they went to in-network providers, letting insurers and health care professionals work out the remaining payment, Joe Grogran, director of the Domestic Policy Council, told reporters Thursday.” [CNN, 2/9/19]
Trump’s Medicare Advantage Executive Order Further Empowered Medical Service Providers To Opt Out Of Medicare Which Potentially Exposed Seniors To Surprise Medical Bills. According to NPR, “Vowing to protect Medicare with ‘every ounce of strength,’ President Trump spoke last week to a cheering crowd in Florida. But his executive order released shortly afterward includes provisions that could significantly alter key pillars of the program by making it easier for beneficiaries and doctors to opt out. The bottom line: The proposed changes might make it a bit simpler to find a doctor who takes new Medicare patients, but it could lead to higher costs for seniors and potentially expose some to surprise medical bills, a problem from which Medicare has traditionally protected consumers.” [NPR, 10/8/19]
Prior To Trump’s Executive Order, Few Physicians Actively Chose To Opt Out Of Participating In Medicare Program. According to NPR, “Right now, the vast majority of physicians agree to accept what Medicare pays them and not charge patients for the rest of the bill, a practice known as balance billing. Physicians (and hospitals) have complained that Medicare doesn’t pay enough, but most participate anyway. Still, there is wiggle room. Medicare limits balance billing. Physicians can charge patients the difference between their bill and what Medicare allows, but those charges are limited to 9.25% above Medicare’s regular rates. But partly because of the paperwork hassles for all involved, only a small percentage of doctors choose this option. Alternatively, physicians can ‘opt out’ of Medicare and charge whatever they want. But they can’t change their mind and try to get Medicare payments again for at least two years. Fewer than 1% of the nation’s physicians have currently opted out.” [NPR, 10/8/19]
Hospitals, Governors, And Medical Professionals Argued That A New, Complex Trump Administration Medicaid Proposal Would Be “Crippling” To Nursing Homes And Hospitals. According to the Orlando Sentinel, “But Florida Medicaid director Beth Kidder wrote to federal Centers for Medicare & Medicaid Services Administrator Seema Verma last month and asserted that a proposal meant to increase transparency related to supplemental Medicaid payments would be ‘crippling.’ ‘It is abundantly clear the CMS (the federal agency) has not sufficiently assessed the substantial consequences this proposed rule would have on both the providers serving and the recipients relying on Medicaid program services that would be impacted by a myriad of the draft positions,’ Kidder wrote in her Jan. 31 letter. ‘While we are unable to calculate the specific impact to all our state programs based on the existing ambiguities in the proposed rule, it is clear that the impact would be immediate and crippling,’ Kidder added.” [Orlando Sentinel, 2/12/20]
Kidder Estimated That The Proposed Changes Meant To Increase Transparency Would Jeopardize $660 Million In Medicaid Funding For Florida’s Nursing-Home Industry. According to the Orlando Sentinel, “But in a letter to Verma, the Florida Health Care Association estimated the proposed changes could jeopardize $660 million in Medicaid funding for the state’s nursing-home industry.” [Orlando Sentinel, 2/12/20]
One Estimate Stated That The Rule Could Reduce Medicaid Spending By 6% To 8%, Or $37 Billion To $49 Billion, A Year Putting Hospitals In Peril Of Closing. According to Pew Trusts, “By one estimate, the rule could reduce Medicaid spending by 6% to 8%, or $37 billion to $49 billion a year. That analysis, prepared by Manatt Health for the American Hospital Association, also estimated that the rule could deprive hospitals of 13% to 17% of the federal Medicaid payments they now receive, or between $23 billion and $31 billion a year. That reduction, policy analysts and advocates say, could put hospitals in peril of closing, particularly rural hospitals that already are shuttering at unprecedented rates. ‘It’s a killer,’ said John Henderson, CEO and president of the Texas Organization of Rural and Community Hospitals, of the rule. Twenty-one of the 107 rural hospitals that have closed in the United States since 2012 were in Texas, more than any other state. ‘They can’t take another punch.’ Nursing home officials also say they fear closures if the rule is implemented.” [Pew Trusts, 2/28/20]
The Trump Administration Claimed The Rule Would Increase Transparency Within The Medicaid System. According to Pew Trusts, “The Trump administration said the rule would increase transparency and prevent abuses that enable states to draw down more federal money than they’re entitled to.” [Pew Trusts, 2/28/20]
2016: President-Elect Trump: I Am Going To Bring Down Drug Prices. According to Reuters, “President-elect Donald Trump took aim at drugmakers on Wednesday by promising in a magazine interview that ‘I’m going to bring down drug prices,’ sending shares of pharmaceutical and biotechnology companies lower. In a cover story for Time magazine, which named him its Person of the Year, Trump said: ‘I don’t like what has happened with drug prices.’ The Republican U.S. president-elect, a wealthy real estate developer who ran a campaign with a populist appeal, did not state in the interview how he would reduce the cost of prescription drugs. Trump previously has suggested he was open to allowing importation of cheaper medicines from overseas.” [Reuters, 12/7/16]
October 25, 2018: Trump Stated That Lower Drug Prices Were “One Of My Highest Priorities.” According to a transcript of remarks by President Trump on Prescription Drug Prices, “I’ve been talking about drug price reductions for a long time. And now we’re doing things that nobody was, let’s say — because I’m speaking on behalf of all of us — bold enough to do. And they’re going to have a tremendous impact […] Since the day I took office, I have made reducing drug prices one of my highest priorities.” [Transcript of Remarks by President Trump on Prescription Drug Prices, 10/25/18]
January 7, 2020: The Year Began With Prices Hikes On Hundreds Of Prescription Drugs. According to the Hill, “Price hikes on hundreds of prescription drugs to start the year are leading to intensifying calls for action from lawmakers and advocates, putting new pressure on Washington. Drug companies kicked off the year by raising prices on a wide range of treatments by an average of about 5 percent, according to the consulting firm 3 Axis Advisors.” [The Hill, 1/7/20]
Trump Medicare Cuts Could Raise Prices On Some Prescription Drugs. According to Forbes, “About 11 percent of the cost savings would come from changes in the Medicare Part D drug benefit. Some beneficiaries would pay more out of pocket for prescription drugs and others less, depending on what medications they take and how much they cost. [Forbes, 3/14/19]
2019: Trump: Drug Prices Are Coming Down For The First Time In 51 Years Because Of My Administration. According to a Washington Post transcript of Trump’s Rose Garden remarks, “Drug prices are coming down, first time in 51 years, because of my administration. But we can get them down way lower, working with the Democrats. We can solve the problem of the border in 15 minutes if the Democrats would give us a few votes.” [Transcript of Trump’s Rose Garden Remarks - Washington Post, 5/22/19]
PolitiFact: Trump’s Claim That Drug Prices Were The Lowest In 51 Years Because Of His Administration As “Mostly False.” According to PolitiFact, “President Donald Trump repeated a misleading claim about the cost of prescription drugs under his watch. ‘Drug prices are coming down, first time in 51 years because of my administration, but we can get them down way lower working with the Democrats,’ Trump said in a May 22 address in the Rose Garden. Trump called a news conference to push back against House Speaker Nancy Pelosi’s comments accusing Trump of a cover-up related to congressional probes of his administration. We fact-checked a similar statement in April by Mick Mulvaney, the acting White House chief of staff, rating it Mostly False. Nothing has changed our conclusion since then.” [PolitiFact, 5/22/19]
Coronavirus Hit Older Adults Hard Than Other Age Groups Due To Underlying Conditions And Weaker Immune Systems. According to Medical News Today, “In this Special Feature, we examine the impact that the pandemic has had on another group that gets frequently overlooked: older adults […] The COVID-19 disease, in itself, has hit older adults harder than other age groups. Older adults are more likely to already have underlying conditions such as cardiovascular disease, diabetes, or respiratory illness — comorbidities that we now know raise the risk of severe COVID-19 and COVID-19-related death. In addition, a likely weaker immune system makes it harder for older adults to fight off infection.” [Medical News Today, 5/19/20]
World Health Organization Data: In April 2020, More Than 95 Percent Of COVID-19 Deaths Were Among People Over 60 Years Of Age. According to Medical News Today, “As a result, the impact on older adults is notable. According to World Health Organization (WHO) data from April 2020, more than 95% of COVID-19 deaths were among people over 60 years of age, and more than half of all deaths occurred in people of 80 years-plus.” [Medical News Today, 5/19/20]
Unique Needs Of Seniors Meant Many Were Unable To Socially Distance. According to Wired, “Whether they live in a long-term care facility, nursing home, or in a family home, many seniors have unique needs that make it impossible for them to socially distance. Some need help eating, washing, going to the bathroom, or moving around. “You can’t do that using Facetime,” says Eric Widera, a professor at the University of California San Francisco who specializes in geriatric and palliative medicine. [Wired, 5/14/20]
Widespread Testing Was Necessary To Safely Allow States to Reopen. According to the New York Times, “From the beginning of the coronavirus crisis, lapses by the federal government have compromised efforts to detect the pathogen in patients and communities. A diagnostic test developed by the Centers for Disease Control and Prevention proved to be flawed. The F.D.A. failed to speed approval for commercial labs to make tests widely available. All of that meant that the United States has been far behind in combating the virus […] ‘It is great that we are flattening the curve,’ said Dr. Mark McClellan, director of the Margolis Center for Health Policy at Duke University, who worked in the George W. Bush administration and is advising state and federal policymakers on the virus response. ‘But for this next phase, where we are really aiming to detect and stamp out smaller outbreaks before they get so big, testing is critical for that,’ he said. “So we have to plan ahead now for much larger capacity.” [New York Times, 4/15/20]
An 83-Year-Old Man Who Was In Good Physical And Mental Health Passed Away After Experienced Delirium From Surgical Anesthesia That Was Exacerbated By 30 Days Spent Alone In The Hospital Due To COVID-19 Related Visitation Policies. According to a USA Today op-ed by Dr. Martha Presley and Dr. Bill Frist, “Coronavirus has changed the way we see life and health care. The immediate focus has been on infected patients. However, the effects of the pandemic are more widespread. Here are two patient stories that emphasize the far-reaching impact of COVID-19: Mr. Smith was an 83-year-old man who was in good physical and mental health, until he fell and broke his hip. He underwent surgery, but as many elderly patients do, suffered delirium from the surgical anesthesia. His delirium worsened with new medications and no family to help orient him to a normal daily routine. In bed with medical devices, new medications and no family is a recipe for disaster. But Mr. Smith could not have his family visit because of the appropriate visitation policies. He spent 30 days alone in the hospital. His delirium worsened, and eventually his wife chose to transition to hospice so she could be with him. He died a week later.” [Dr. Martha Presley and Dr. Bill Frist – USA Today, 6/15/20]
Social Isolation And Loneliness Were Well-Known Factors For Increased Mortality In Patients With Advanced Disease And Age. According to a USA Today op-ed by Dr. Martha Presley and Dr. Bill Frist, “These cases illustrate the impact of isolation on elderly mortality. Hip fractures are serious in patients over 70 years old. But for Mr. Smith, his one-year mortality was only about 27%. With family support, he was likely to recover. For Ms. Jones, her prognosis was poor. Patients with advanced dementia over 70 who break a hip have a 55% six-month mortality. However, without social isolation and resultant loneliness, agitation and increased medication, Ms. Jones might not have fallen and possibly would have had more months to live. Coronavirus is particularly deadly for the elderly. In 14 states, half of COVID-19 deaths are in long-term care facilities, and the deaths of the residents and workers account for a third of the national death toll. But those are just the deaths from infected patients. Mr. Smith and Ms. Jones did not die from COVID-19. They died because of it.” [Dr. Martha Presley and Dr. Bill Frist – USA Today, 6/15/20]
National Church Residences Chief Medical Officer Dr. John Weigand: Without Widespread Testing, Senior Living Communities Were COVID-19 “Tinderboxes.” According to Senior House News, “Using community-wide testing, senior living providers can learn who is truly positive for Covid-19 — not just confirm cases among those who are symptomatic — and therefore more effectively manage the disease by separating the sick from the healthy. ‘Every one of these facilities is like a tinderbox, and every positive staff member or resident is a lighted match,’ National Church Residences Chief Medical Officer Dr. John Weigand told SHN. ‘To presumptively say the people who have symptoms are positive, and those who don’t have symptoms are negative, is foolhardy.’” [Senior Housing News, 4/22/20]
Dr. Martha Presley & Dr. Bill Frist: Universal Testing In Long-Term Care Facilities Must Be A Priority. According to a USA Today op-ed by Dr. Martha Presley and Dr. Bill Frist, “There are many people who are even less fortunate than these patients, who spend their final days in institutions without any loved ones by their side. Universal testing in long-term care facilities and visitations in hospitals for the elderly should be a priority. Facility testing has been recommended by the White House, and many states are implementing testing for patients and staff and screening for visitors. The most significant issue is cost: One group estimates almost $440 million if every nursing home patient and staff member in the United States were tested. These costs can be decreased. ‘Pooling’ would allow batch testing, which could reduce cost as much as 80%. Though this is still significant, testing and screening should be a priority because of the high cost of prolonged admissions and the cost of life from preventable deaths.” [Dr. Martha Presley and Dr. Bill Frist – USA Today, 6/15/20]
Dr. Martha Presley & Dr. Bill Frist: Policymakers Should Create A Comprehensive Plan To Enable Visitation For Elderly Patients. According to a USA Today op-ed by Dr. Martha Presley and Dr. Bill Frist, “In addition to testing, policymakers should focus on a comprehensive plan to safely enable visitation for elderly patients in facilities and hospitals. The strategy should include testing for all patients and staff, but also screening for visitors, proper use of masks, availability of hand hygiene and a plan for isolating infected patients.” [Dr. Martha Presley and Dr. Bill Frist – USA Today, 6/15/20]
Trump’s Rush To Open The Country Made Seniors Feel That Their Lives Were Expendable. According to Kaiser Health News, “Making it worse, some seniors fear that their lives may be seen as expendable in the rush to reopen the country. ‘[Older adults] are wondering if their lives are going to end shortly for reasons out of their control,’ said Dr. Linda Fried, dean of the Mailman School of Public Health at Columbia University, in a university publication. ‘They’re wondering if they’ll be able to get the care they need. And most profoundly, they’re wondering if they are going to be cast out of society. If their lives have value.’” [Kaiser Health News, 5/28/20]
May 11, 2020: A Least 28,100 Residents And Workers Died From The Coronavirus At Nursing Homes And Other Long-Term Facilities For Older Adults. According to the New York Times, “At least 28,100 residents and workers have died from the coronavirus at nursing homes and other long-term care facilities for older adults in the United States, according to a New York Times database. The virus so far has infected more than 153,000 at some 7,700 facilities […] While just 11 percent of the country’s cases have occurred in long-term care facilities, deaths related to Covid-19 in these facilities account for more than a third of the country’s pandemic fatalities.” [New York Times, 5/11/20]
New York Times: “While Just 10 Percent Of The Country’s Cases Have Occurred In Long-Term Care Facilities, Deaths Related To Covid-19 In These Facilities Account For More Than A Third Of The Country’s Pandemic Fatalities.” According to the New York Times, “While just 10 percent of the country’s cases have occurred in long-term care facilities, deaths related to Covid-19 in these facilities account for more than a third of the country’s pandemic fatalities. [New York Times, 5/11/20]
The Government Failed To Track Nursing Homes And Long-Term Care Facilities With Coronavirus Outbreaks. According to NBC News, “On April 19, Medicare Administrator Seema Verma took the podium at the White House's daily coronavirus briefing to announce that the Trump administration would begin tracking outbreaks and deaths at long-term care facilities nationwide — and publish the numbers for everyone to see. The effort would begin within days, federal officials promised. More than two weeks and 13,000 long-term care deaths later, the federal government still has not tallied the number of nursing homes that have had outbreaks nationwide or the number of residents who have died. And the data is still weeks away from being made public, according to the Centers for Medicare and Medicaid Services, or CMS, the federal agency that oversees nursing homes.” [NBC News, 5/8/20]
The Delay In Data Collection Hampered Officials Ability To Target Hot Spots And Send Additional Resources Where They Were Needed. According to NBC News, “The delay in data collection is one of a number of bottlenecks in the effort to slow the virus' deadly spread in nursing homes across the U.S., hampering officials' ability to target hot spots and send additional resources where they are needed, according to public health experts. The administration has also been slow to send supplies of personal protective equipment, or PPE, to long-term care facilities, and it delayed a requirement that nursing homes report coronavirus outbreaks to family members. A requirement that families be notified of outbreaks was approved on April 19 but didn't go into effect until Friday.” [NBC News, 5/8/20]
LeadingAge: The Lack Of Testing And PPE Has Left Older Americans ‘To Fend For Themselves As The Virus Threatens To Wipe Out An Entire Generation.’ According to NBC News, “‘The nursing home industry says knowing the scope of the problem and which facilities should get priority is crucial. The need for greater access to testing and protective equipment has become even more urgent as more states are beginning to ease restrictions and reopen, effectively leaving older Americans "to fend for themselves as the virus threatens to wipe out an entire generation,’ LeadingAge, which represents nonprofit long-term care facilities, said in a statement.” [NBC News, 5/8/20]
The Trump Administration Did Not Require Nursing Homes To Provide Data About COVID-19 Deaths And Cases That Occurred Prior To May 6. According to NBC News, “The Trump administration is not requiring nursing homes to provide data on COVID-19 deaths and cases that occurred prior to May 6, according to a public government document, limiting the accuracy of the federal data collection effort to measure the impact of the pandemic on older Americans. The government encourages nursing homes to provide the data from before May 6, but does not mandate it. The limitations of the data collection effort were first reported by the Wall Street Journal. ‘I think that is outrageous,’ said Charlene Harrington, nursing professor emerita from the University of California San Francisco, who said the administration was aiding the nursing home industry by ‘helping them cover up the death rates.’ ‘Not only do the high death rates look bad for the nursing home industry," she said, "but also for the administration.’ In the absence of any federal tracking effort of deaths and outbreaks in nursing homes, numerous media outlets, including NBC News, have tracked the deaths using data provided by individual states. The most recent computation by NBC News found that as of May 11 at least 27,000 older Americans who were residents of long-term care facilities had died.” [NBC News, 5/22/20]
Nursing Homes Struggled To Get PPE And Coronavirus Tests. According to CNN, “Even inside nursing homes -- deemed a ground zero for the spread of coronavirus -- health care workers still don't have enough personal protective gear and the facilities can't get testing done quickly enough to effectively fight the virus […] More than a month after Life Care Center in Kirkland, Washington, was designated the epicenter of the state's Covid-19 outbreak, nursing homes like Genesis' on the East Coast and across the country are seeing coronavirus cases and deaths climb in their facilities, as they still fight for access to protective gear and testing. Over the past several weeks, the attention on supply shortages had largely focused on the availability of face masks and getting supplies to hospitals. Nursing homes, where severe cases of the virus spread especially easily, have been getting more help in recent weeks, depending on the state. But they're still facing a catastrophic situation.” [CNN, 4/21/20]
Despite Federal Authorities Pledging That “Nursing Homes Have Been A Major Focus For The Trump Administration,” They Have Faced Shortages Of Supplies Critical To Fighting COVID-19. According to CNN, “‘Nursing homes have been ground zero for Covid-19,’ CMS administrator Seema Verma said, calling the new reporting requirement ‘critical’ to monitoring the virus' spread and reopening the country. Earlier this month, federal authorities pledged that ‘nursing homes have been a major focus for the Trump Administration in its aggressive efforts to combat the virus.’ But tracking cases inside nursing homes would be just the beginning. Failures inside nursing home systems to get needed supplies have kept them from curtailing the spread of the virus. So far, the Federal Emergency Management Agency is working on a plan to get nursing homes more supplies, Verma said on Sunday. The American Geriatrics Society was still urging the Trump administration's coronavirus task force last week to prioritize protective equipment and testing supply shortages in nursing homes, long-term care facilities and other congregate living settings.” [CNN, 4/21/20]
Nursing Homes Received Defective PPE As Part Of Trump’s Much-Hyped Supply Initiative. According to CNN, “Nursing homes with urgent needs for personal protective equipment say they're getting gowns that look more like large tarps -- with no holes for hands -- and surgical masks that are paper-thin as part of the administration's initiative to bolster supplies for vulnerable populations amid the pandemic. ‘It would be funny if the stakes weren't so high,’ a Washington state official told CNN. In late April, President Donald Trump announced an effort to shore up supplies to nursing homes, whose residents and staff have been among those most at risk of Covid-19. The Federal Emergency Management Agency was at the helm of the effort to send additional shipments to nursing homes. For weeks, nursing home associations have tried to call attention to the elderly population and the lack of supplies to properly care for them. ‘Too often, the only signs of FEMA's much-hyped promise of PPE shipments—an allotment of gowns, gloves, masks and goggles based on staffing size of the provider—are scattershot delivery with varying amounts of rag-tag supplies,’ said Katie Smith Sloan, president and CEO of LeadingAge, an association of nonprofit providers of aging services, in a statement.” [CNN, 6/11/20]
Kaiser Health News: 74% Of Nursing Homes Have Been Cited For Lapses In Infection Control. According to NBC News, “A 2017 analysis by Kaiser Health News found that 74 percent of nursing homes have been cited for lapses in infection control — the most frequent type of health violation.” [NBC News, 3/3/20]
Presidents George W. Bush And Barack Obama Worked To Increase Nursing Home Emergency And Preparedness Standards. According to the Center for American Progress, “after more than 200 nursing home deaths during Hurricane Katrina and 4,500 rescues of residents from adult housing and nursing homes during Superstorm Sandy, former Presidents George W. Bush and Barack Obama worked to increase nursing home emergency and preparedness standards. Though levels of compliance have varied, nursing homes and other long-term care facilities have historically been required to operate under strict standards intended to improve the health and care of their residents as well as the safety of their staff. The Nursing Home Reform Act of 1987 established a residents’ bill of rights that includes rights to communication, self-determination, and freedom from abuse, mistreatment, or neglect. It set up standards of care and a process by which on-site visits by trained professionals enforce compliance with those standards. It also created a series of sanctions and penalties that can be levied if the nursing home is not in compliance. [Center for American Progress, 4/21/20]
2016: Obama Enacted A Series Of Rules That Strengthened Infection Prevention And Levied Higher Fines And Penalties At Nursing Homes. According to the Center for American Progress, “Later, in 2016, the Obama administration enacted a series of rules to improve the treatment of patients in nursing homes and long-term care facilities. These rules strengthened the standards for quality of care and infection prevention and levied significantly higher fines and penalties than those previously in place. They also strengthened the original residents’ bill of rights legislation with a specific focus on the use of binding arbitration.” [Center for American Progress, 4/21/20]
The Trump Administration Rolled Back Federal Rules And Regulations Put In Place By The Two Previous Administrations. According to the Center For American Progress, “Why are nursing homes being hit so hard by the outbreak? One reason is that they are a target of the Trump administration’s aggressive deregulation agenda […] The nursing home lobby rebelled against this increased level of oversight and rising penalties. The inauguration of President Donald Trump and the growing Republican control of Congress saw the beginning of a robust advocacy campaign by the industry to roll back the changes, citing the onerous nature of the standards and the severity of the financial penalties. In March 2017, lobbyists for the nursing home industry also began advocating for changes to the Nursing Home Reform Act. They argued that fines should be significantly lessened or eliminated if there was no harm done to residents or if the situation took place before an inspection. They also asked to eliminate the requirement for nursing homes to evaluate the staffing levels needed to provide adequate care—and wanted residents to agree to binding arbitration should they seek to sue at some point in the future.” [Center for American Progress, 4/21/20]
Trump Relaxed Nursing Home Regulations After An Intense Lobbying Effort From The Nursing Home Industry. According to the New York Times, “The agency also weakened a rule that would have made it easier for nursing home residents and their families to sue over claims of elder abuse, sexual harassment and wrongful death. […] The administration’s moves came after intense lobbying by the nursing home industry, including by the firm run by Brian Ballard, Mr. Trump’s friend and a fund-raiser.” [New York Times, 3/14/20]
Trump Eased Enforcement On Nursing Home Providers, Reducing Penalties By 34%. According to NBC News, “In addition to its efforts to dial back regulations, the Trump administration has also eased enforcement on nursing home providers. Regulators are now encouraged to use one-time fines instead of daily fines for ongoing violations, according to an NBC News investigation last year. This has led to a 34 percent reduction in the overall dollar amount of penalties for nursing homes from 2017 to 2018. The Centers for Medicare and Medicaid Services said at the time that the change was to make punishment ‘fairer, more consistent and better tailored to prod nursing homes to improve care.’” [NBC News, 3/3/20]
Advocacy Groups, Like The Center For Medicare Advocacy, Argued That Lax Federal Enforcement Allowed Violations To Proliferate, Potentially Jeopardizing Nursing Home Residents Who Were Already More Vulnerable To Threats Like Coronavirus. According to NBC News, “‘These are frail, medically compromised people, and they need to have someone focused on infection,’ said Toby Edelman, a senior policy attorney at the nonprofit Center for Medicare Advocacy who opposes the proposed change […] Advocates like Edelman are concerned that lax state and federal enforcement has allowed violations to proliferate, potentially jeopardizing nursing home residents who are already more vulnerable to threats like coronavirus, as well as their surrounding communities.” [NBC News, 3/3/20]
July 2019: The Trump Administration Proposed New Rules Relaxing The Requirements Tied To Infection Control. According to Center for American Progress, “Despite these lobbying efforts, in 2018, U.S. Senate Finance Committee minority staff released a report that demonstrated how a failure of state and federal oversight led to 12 deaths in a Florida nursing home after Hurricane Irma. The report also documented the many others who suffered or died in nursing homes as a result of Hurricane Harvey. In response, the nursing home lobby again advocated for less oversight, and in July 2019, the Trump administration proposed new rules relaxing the requirements tied to infection control. It suggested that consultants could be used, instead of requiring infection specialists to be employed at the site, at minimum, on a part-time basis. This meant that there was no longer a requirement for a full-time, hands-on expert in infection contamination on-site. This lack of additional oversight—combined with the prior regulatory rollbacks on staffing ratios, fines levied for injuries, and requirements for arbitration—served to undermine safety for nursing home patients and staff.” [Center for American Progress, 4/21/20]
CMS Also Proposed Reducing The Frequency Of Facility-Wide Assessments That Nursing Homes Were Required To Conduct To Determine What Resources They Need For Emergencies. According to NBC News, “Last year, the Centers for Medicare and Medicaid Services also proposed reducing the frequency of facility-wide assessments that nursing homes are required to conduct to determine the resources they need for emergencies, as well as day-to-day operations. Nursing homes would only be required to conduct them every two years, instead of annually.” [NBC News, 3/3/20]