Sondra Norder

Over the Memorial Day weekend, Centers for Medicare and Medicaid Services Administrator Seema Verma penned an op-ed in Newsweek magazine titled “President Trump’s Early Action to Combat Coronavirus in Nursing Homes Saved Countless Lives.”  

This is the total opposite of reality. The same agency that required us as long-term care providers to have robust emergency preparedness and infection control plans in place has consistently lagged behind our decisive action.

At the end of February, despite what the nation saw unfolding in Kirkland, WA, there was zero specific direction from any federal agency about how to prepare for this crisis or how to protect those we serve and employ.

On March 4, despite President Trump assuring the nation that COVID-19 was controlled, we activated our organization’s official Incident Command, and for the next nine days, we systematically implemented screening and surveillance procedures and visiting restrictions until we made the decision on March 12 to completely close to visitors and require universal masking due to the escalating threat to those we serve.  Many of our colleagues followed the same timeline in terms of visiting restrictions and emergency response in general.  

Then on March 13, several days after most providers started shutting down to visitors and requiring source control masking on our own accord, CMS directed both policies be implemented. We took early action. The president and his administrative agencies followed our lead.  

The unchecked transmission of this virus during February and March has led to over 100,000 deaths in this nation to date, almost half of which are linked to long-term care facilities. Many of those individuals died after having had advanced care planning conversations with facility staff about their wishes, should they become critically ill. Hospitals were overwhelmed by this virus and had scarce ventilators and intensive care options, so we assumed the burden of having conversations with the people least likely to survive a COVID-19 infection.  

The idea that “President Trump’s early action saved countless lives” also ignores our current reality in long-term care. Aging services workers continue to live in lockdown as our communities reopen, which has been encouraged and directed by the President, despite the ongoing threat to the lives of our residents.  

On May 13, CMS released a “toolkit” of “best practices” for mitigating the prevalence of COVID-19 in nursing homes; it is a list of hyperlinks, many of which contain entirely inaccurate or outdated information. The following day, both national nursing home advocacy associations told their members that they were not recommending use of the CMS toolkit due to serious concerns about the materials cited. Indeed, CMS included a disclaimer with the toolkit stating it should not be used as guidance, and that the actions outlined in the compendium had not been evaluated by CMS or any federal agency for effectiveness.  

The abject incompetence continued as we received shipments of “PPE” from the U.S. Department of Health and Human Services.  While the president boasted that “PPE” has been sent to all 15,000 nursing homes nationwide, we received cloth masks made from Hanes white T-shirt material that included directions not to wash them in any chemical.  

CMS has now released guidance to states regarding nursing home infection control inspection and enforcement action.  It is as punitive as anything we have ever seen, and it is as obvious that blaming nursing homes is the latest deflection from this national failure. 

Seema Verma’s op-ed is a similar attempt to rewrite history. It is stolen valor from the heroes of long-term care who have fought so hard against a virus that has been called a perfect elderly killing machine. This revisionism must not go unchecked.

Sondra Norder, J.D., NHA, HSE, FACHE, is president and CEO of St. Paul Elder Services Inc., in Kaukauna, WI. 

Editor’s Note: McKnight’s Long-Term Care News accepts columns representing a variety of viewpoints. Columns do not necessarily reflect the views of the editors or organization.