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Nursing home residents and their loved ones deserve a nonpartisan review of state's pandemic decisions

Intelligencer Journal - 4/7/2021


As of Monday, 12,942 people with COVID-19 had died in Pennsylvania nursing homes since the pandemic began; that represents half of the 25,200 total COVID-19 deaths in Pennsylvania, according to state figures. Republican state House Majority Leader Kerry Benninghoff, of Centre County, has asked the House Government Oversight Committee to review any guidance or public information provided on nursing home referrals by three state agencies, the Health, Aging and Human Services departments. “The state’s death figures from nursing homes — at times inconsistent and incomplete during the pandemic — are also at issue,” Brad Bumsted, bureau chief with The Caucus, an LNP Media Group watchdog publication, reported in Monday’s edition.

We strongly support a thorough assessment of the state Department of Health’s handling of nursing homes during this pandemic. But only if it’s going to be a genuine investigation and not an exercise in political point-scoring.

Too often, these investigations are just aimed at striking at a political opponent’s weak side with the goal of causing embarrassment. The COVID-19 pandemic and its impact on Pennsylvania’s seniors are far too serious for that kind of partisan nonsense. The genuine — not merely stated — aim should be to ensure that any missteps made aren’t repeated in the future.

We’ve watched with a skeptical eye as some Republican lawmakers have tried to link Gov. Tom Wolf with beleaguered New York Gov. Andrew Cuomo, whose administration officials manipulated and concealed data on nursing home deaths in that state.

Our view on this is similar to that expressed by state Rep. Clint Owlett, R-Tioga County, who said at a press conference last month that he believed Wolf was “trying to do what was best.” That was our view, especially early in the pandemic, when state officials did not know what the crisis would bring.

Owlett also said this: “We want answers for the people who lost loved ones in our nursing homes.”

We do, too. The people who lost loved ones don’t just want answers — they need them and deserve them.

And the Wolf administration repeatedly has failed to meet the standard for accountability that Wolf himself set when he became governor.

As we’ve noted again and again, transparency engenders trust, which is imperative in a crisis. If people are suspicious about how state health officials handled nursing home admissions, those officials only have themselves — not Republicans — to blame.

All of this — the need for an investigation and the politicking around it — could have been avoided had state Department of Health officials been clear and transparent from the beginning.

As Bumsted explained, “The flashpoint in a legislative investigation of deaths related to COVID-19 in Pennsylvania nursing homes centers on just one word: ‘must.’

“Republican lawmakers claim Gov. Tom Wolf put lives at risk last year when his Health Department issued guidance saying nursing homes ‘must’ admit stable COVID 19 patients.”

As Bumsted reported, the federal Centers for Medicare and Medicaid Services, which sets the standards for U.S. nursing home care, issued guidance March 13, 2020, saying nursing homes “can accept” stable COVID-19 patients but did not have to do so.

“As the hands-on inspector of nursing homes in Pennsylvania, the (state) Department of Health followed up on the CMS guidance in a March 18 message to home administrators,” Bumsted wrote. “That guidance changed the CMS language from ‘can accept’ patients who had COVID-19 to ‘must.’

“Wolf administration officials say it’s not appropriate to focus solely on the March 18 guidance, noting that several additional memos sent to nursing homes echoed the voluntary language issued by CMS.”

Barry Ciccocioppo, spokesman for the state Department of Health, told Bumsted that additional state guidance reiterated that the state was not making it mandatory that nursing homes admit COVID-19 patients.

“One section of the DOH guidance has been extracted and represented without context,” Ciccocioppo said.

We understand the fog of war that often accompanies the early days of a crisis, especially something like a once-in-a-century pandemic.

But there’s no denying that the state’s guidance added to that fog, instead of cutting through it.

Ciccocioppo said the March 13, 2020, memorandum issued by CMS was mandatory. Pennsylvania’s subsequent guidance just was intended to clarify it, he said.

But we understand why nursing home administrators might have felt compelled to follow the state guidance.

“Put yourself in the shoes of an administrator or front-line caregiver,” Zach Shamberg, president and CEO of Pennsylvania Health Care Association, told Bumsted. “Ask any nursing home what happens when a guidance is reviewed and not followed.”

Adam Marles, president and CEO of LeadingAge PA, a statewide association representing nonprofit providers of senior housing, health care and community services, called the state’s March 18, 2020, order both “bad policy” and “confusing” for association members.

In a virtual meeting last month with the LNP | LancasterOnline Editorial Board and two leaders of local senior communities, Marles said that policy was not enforced by the state, but did seem to empower hospitals — essential referral sources for nursing homes — to insist that nursing homes take admissions.

John Sauder, president and CEO of Mennonite Home Communities, said the state policy had little impact on his organization.

Of far greater impact, the senior community leaders said, was a state response that failed — and still is failing — to prioritize nursing homes and senior citizens.

Larry Zook, president and CEO of Landis Homes, also pointed out the devastating impact that the community’s failure to stem COVID-19’s spread had on nursing homes. “As the virus spreads in the community, there’s really no way to build a moat around a senior living setting,” he noted.

There clearly were multiple factors that led to the horrific number of nursing home deaths in Lancaster County and Pennsylvania. (As of Monday, Lancaster County had seen 978 COVID-19 deaths, nearly half of which occurred in skilled nursing or long-term care facilities.)

So there’s no real reason for state Health Department officials to be defensive. They ought to acknowledge that they failed to be as consistently transparent as they should have been, and that they made some decisions last year that added to the confusion. And they ought to welcome good-faith efforts to examine what happened in Pennsylvania’s nursing homes and cease hiding behind claims that Republicans are merely playing politics.

And Republicans ought to ensure that they’re acting in good faith and refrain from playing politics.

It didn’t help their cause when state Rep. Daryl Metcalfe, R-Butler County, made nursing home deaths a focus of his February resolution aimed at impeaching Wolf. Nor does the fact that Metcalfe got more than two dozen Republican lawmakers — including Reps. Dave Zimmerman, of East Earl Township, and Jim Cox, of Berks County — to co-sponsor his impeachment resolution.

The lives and deaths of Pennsylvania’s seniors should not be weaponized in dumb political battles. They and their loved ones deserve answers honestly sought and delivered.

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