Brendan Williams

My son is a freshman at a public university in the state of Washington that made the abrupt decision, late afternoon on the last day one could withdraw and receive a tuition refund, to go to online instruction until January 24 due to the uptick in COVID-19 cases.

That decision is symbolic of the crazy quilt of public health guidance that we must navigate.  Nine days prior to it 68,043 screaming fans were present at Lumen Field in Seattle to watch the Seahawks play the Detroit Lions.  Presumably this gigantic gathering met the exacting public health safeguards of a state that has been very stringent throughout the pandemic.  Go figure.

Yet contrast the caution of my son’s university with the laissez-faire attitude of the federal government toward nursing home visitation.  An administration that seeks to impose a vaccine mandate upon nursing home workers – a proposition most of the public supports and a Supreme Court majority may embrace – will not allow nursing homes to even require a negative test for those entering to visit residents, let alone proof of vaccination. 

Meanwhile cases are going up.  On January 5 New Hampshire had 120 cases in long-term care facilities, compared to zero last June 13.  Community spread is a full-blown crisis.  Last June 13 there were 28 cases in New Hampshire identified outside of long-term care facilities.  On January 8 there were 3,231.       

Are we really living in a world in which a university that requires vaccination and mask-wearing shuts down in-person instruction to safeguard those least at risk from COVID-19 while nursing homes must let COVID-19 waltz in through the front door?  A world in which a Supreme Court majority that has been skeptical about restrictions on public gatherings, striking down some as unconstitutional, still refuses to allow the public to enter its hallowed halls due to COVID-19 risk?

Even the decision by states and the federal government to provide rapid-result tests to the public betrays a damning relativism when it comes to nursing home care.  My members are testing all the time, and the supply of point-of-care tests like the Abbott BinaxNOW test can hardly meet their demand.  Worse, some tests being supplied through the federal government are expired.  I suppose this is all in the interest of making sure those like Bill Gates and Jeff Bezos can receive their free at-home tests from King County, the state of Washington, and the U.S. taxpayers. 

What a difference a couple years makes.  When COVID-19 first began its spread, a tragic national toll in long-term care was exacerbated by policy decisions, with the nadir being New York’s deadly decision to flood its nursing homes with COVID-positive hospital discharges.

A commission was formed by the federal government to study the crisis besetting nursing homes, and in September 2020, among other things, recommended a permanent 12% increase in annual Medicaid payments (about $10,000 a bed) to increase staff salaries and buy equipment.

As this recommendation would require states to foot no less than half the bill, based upon the cost-sharing Medicaid formula, it found no traction. The 186-page report has long been lost to Washington, D.C., recycling bins. 

Now we cannot even get the Federal Trade Commission to shoo away the staffing agency vultures that are price-gouging providers, a trend that, unchecked, will inexorably destroy the nursing home sector.  But, hey, at least Bill Gates and Jeff Bezos will get those free test kits!

Brendan Williams is the president and CEO of the New Hampshire Health Care Association.