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AARP Creates COVID-19 Dashboard to Help Nursing Homes

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As COVID-19 still continues its rampant spread among nursing home residents and staff, valuable and accurate data pinpointing areas of concern is often rife with haphazard data collection providing skewed information. The most recent Kaiser Family Foundation data analysis indicates that federal policymakers are slow in meaningful response to the nursing home coronavirus crisis. The increasing loss of life is often due to this inadequate federal and state response during this fall flu season. To better address the concerns, AARP has created a COVID-19 Dashboard that will standardize information collection and provide better data integrity. The 5-point plan aims to save lives by better protecting nursing home and long-term care facility residents at state and federal levels through more accurate data collection and its use in timely responsiveness.

  1. Ongoing testing and sufficient personal protective equipment (PPE) for residents and staff must be a priority. PPE must also be readily available for inspectors and any visitors.
  2. Create better transparency with a focus on the daily public reporting of COVID-19 cases and deaths in facilities. Improving communication with families about transfers and discharges and increase accountability for state and federal funding provided to facilities.
  3. Following federal and state guidelines for safety, ensure access to in-person visitation as well as the continuation of virtual visitation for all residents.
  4. Ensure residents’ quality care via adequate oversight, staffing, and access to in-person formal advocates known as long-term care Ombudsmen.
  5. Reject immunity as it relates to COVID-19 for long-term care facilities.

The AARP Nursing Home COVID-19 Dashboard is a collaboration between the AARP Public Policy Institute and the Scripps Gerontology Center at Miami University in Ohio. The dashboard is a four-week snapshot of the coronavirus infiltration into nursing homes and its impact on residents and staff. The goal is to promptly identify specific areas of concern at a state and national level.

A second dashboard will aggregate and analyze the self-reported data from nursing homes provided by the Centers for Medicare and Medicaid Services (CMS) that cover specific three 4-week time intervals from mid-summer into autumn. This dashboard will specifically gather five key measures from nursing homes: resident death per 100 residents, resident cases per 100 residents, staff cases per 100 residents, percentage of nursing homes without a one-week supply of PPE, and percentage of nursing homes with staffing shortages. There will also be an additional 33 data points providing more information about each category and updated every month. As tracking continues and trends present themselves, additional categories will evolve to follow other measures of interest.

The second dashboard already presents five key findings, including:

  1. Nursing home resident and staff COVID-19 deaths and cases had been on the decline at a national level during the summer. The 2020 flu season brings an uptick to cases, and coronavirus community spread continues to rise rapidly throughout most of the country, increasing vulnerability to nursing homes, staff, and residents.
  2. State trends vary dramatically. Many states with previously high death and infection rates in the summer are improved in the most recent weeks; however other states, particularly in the Midwest, see rapidly increasing rates of cases and deaths in nursing homes.
  3. The variation across states can be as high as about 1 out of every 52 nursing home residents to no resident deaths in the four weeks between September 21 to October 18. Nationally, the same reporting period reported an average death rate of one in every 215 residents.
  4. Direct care staff continues to have infections at a very high rate during this same period from September to October. While more than one-quarter (26 percent) of nursing home residents had confirmed COVID-19 cases, twice as many (53 percent) had confirmed staff cases. More than 90 percent of the nursing home staff tested positive for the coronavirus in the hardest-hit states.
  5. All states indicate nursing homes have a PPE shortage, which is defined as not having a one-week supply of surgical masks, N95 masks, gloves, gowns, and eye protection. In the best-performing state, only 5 percent of nursing homes reported a PPE shortage, while the lowest-performing state had 53 percent of nursing homes reporting a PPE shortage.

Reliable, timely data regarding nursing homes and COVID-19 can help facility operators and personnel gain a better understanding of the crisis facing nursing homes and other long-term care facilities. The federal government has begun to require nursing homes to self-report COVID-19 cases and deaths at the national level and ordering testing, providing PPE, issuing guidance for the re-instituting of in-person visits, and more. However, as cases and deaths continue to rise, AARP and other organizations will continue to accumulate data and shine a light on the tragedy befalling nursing home residents to make policy and lawmakers accountable to the crisis. AARP has a webpage providing more information for you or a loved one in a nursing home.

If you have questions about anything you have read or would like to speak to us about planning for you or a loved one, please don’t hesitate to reach out. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help.

Are Divorce Rates Up Because of COVID -19?

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Are divorce rates up because of Covid? The answer depends on who you ask.

Some experts report an increase.

The National Law Journal reports that divorce inquiries were up  34% by April of 2020. Mostly couples married less than five years.  And marriages that were already rocky are pushed over the edge. Shelter-in-place, homeschooling, and arguments about parenting increased the stressors on already troubled relationships.  Add financial stress and boredom, and nerves get raw.   As a result, the Journal believes there will be an increase of 10% to 20% in the second half of 2020. https://www.natlawreview.com/article/divorce-rates-and-covid-19

On the other hand, some experts report a decline.

In contrast,  professor Brad Wilcox, believes divorce rates have actually fallen. He credits the decrease to two likely factors.  First, it was hard to file for divorce when the courts were closed.  Second, in some marriages, hardship makes the relationship stronger. Couples developed a new appreciation for each other.  Couples who live the “we before me” rather than the “me first” lifestyle Wilcox talks about in his book “We Before Me”  have a better chance of surviving. https://news.virginia.edu/content/qa-professor-sets-record-straight-2020-divorce-rate

What is reality?  Are divorce rates up because of Covid-19?

What is reality? Are divorce filings up because of Covid? Goff and Goff has seen an increase in inquiries over the last several months. It became easier to file once the shelter-in-place order was lifted. Until then, most court proceedings were on hold resulting in less filing. As a result divorce filings historically spread over many months, are now happening in a compressed timeframe.    Only time will tell if the stresses of COVID kills more marriages.  Right now, there doesn’t seem to be a real increase in North Louisiana.  At least not yet.

If you and your spouse are on each other’s last nerve, get professional help.  Marriage counseling can be very effective and it is always worth a try.   Also, check out Dr. Wilcox’s book “We Before Me” (coming soon).

If you have a question about divorce call us at 318-255-1760, email us at info@goffandgoffattorneys.com  or  visit our online appointment scheduler to book a consultation.  We’re here to help!

The Unfortunate Increase of Elder Abuse During the Pandemic

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Whether at home or in a long-term care facility, America’s elderly are facing increasing incidents of mistreatment and abuse as social isolation during the pandemic creates more vulnerabilities. Stay-at-home guidelines isolate seniors from the systems that can protect them like medical providers, congregations, extended family, and senior centers. The high rate of coronavirus deaths for those Americans 70 and older increases fear and their dependency on those who might seek to take advantage of them. Sadly, most of these abusers are family members, such as an adult child or spouse, followed by caregivers or staff in a long-term care facility.

The Center for Disease Control and Prevention (CDC) lists four common types of elder abuse: physical, sexual, emotional, psychological, and neglect and financial abuse. Many incidents of elder abuse, neglect, and exploitation are underreported, especially during social isolation. According to a PBS report, Paul Caccamise, the vice president for program at Lifespan, Rochester, NY, says that the stream of calls reporting abuse is lower than usual. Yet, elder abuse has not gone away during the pandemic. Many referrals of abuse to Lifespan come from home care agencies, physicians, or hospitals, reporting suspected signs of abuse. Now that many older Americans are avoiding interactions with doctors and hospitals, the monitoring function is no longer available. Similarly, for those elderly in long-term care facilities, family members are no longer allowed direct access to check on the welfare of their loved ones.

This situation is not exclusive to New York. Across the country, the number of reports of elder abuse is decreasing during the coronavirus pandemic. The Minnesota Elder Justice Center’s executive director Amanda Vickstrom understands that although the quantity of cases is down, the amount of help our elder Americans need is up. About the disparity in case reports versus senior needs, Vickstrom states, “It doesn’t tell me that suddenly we’ve reduced elder abuse. It tells me that people are unable to reach out for help.”

Other support groups for the elderly like the National Clearinghouse on Abuse in Later Life (NCALL) are seeing similar trends. NCALL founder Bonnie Brandl says, “Abusers are using the threat of the virus and the isolation to provide misinformation to people.” Isolated seniors can fall prey to threats of being visited by a caregiver who may have been exposed to the coronavirus or sent to a nursing home where COVID-19 death rates are disproportionately high.

Caregiver promises to keep a senior safe if they hand over checks or other assets during this pandemic is not uncommon as many Americans have lost their jobs or have reduced hours of income and are facing financially tough times. If the senior lives with an abuser, the situation can become desperate as abusers can threaten to hurt or manipulate the senior who, in isolation, has little confidence to seek outside help. The coronavirus pandemic, which already disproportionately impacts older people’s health, makes them more vulnerable to abandonment, neglect, financial, emotional, sexual, and physical abuse.

The increase of seniors’ dependency on their caretakers at home and staff in long-term care facilities can incentivize abusers to target these older adults. Many seniors are targeted as they have resources saved, consistent monthly incomes from investment sources, or Social Security benefits. Desperate for their health and safety, many seniors will turn over their money, hoping that it will be key to their survival. There are also thousands of reports of scam artists offering bogus or nonexistent free home test kits or fake cures, posing as counterfeit charities, or preying on other virus-related fears to gain personal information or money.

If you have a senior family member who is socially isolated due to COVID-19, it is crucial to stay engaged with them to prevent their mistreatment. There are programs available that help those who face isolation to stay connected. AARP and the Tennessee Commission on Aging and Disability have programs that provide weekly phone checks provided by vetted volunteers who can spot trouble signs. There are other nonprofits such as FiftyForward, Senior Ride Nashville, Eras Senior Network of Wisconsin, and many others that check to see that seniors have proper resources during the pandemic such as food and medication. Volunteers will also address the emotional needs seniors have during isolation. For many seniors, it will be the only conversation they will have that day. Check with your community and see how you can best protect your senior during the social isolation and vulnerable times of the COVID-19 pandemic.

If you have questions or would like to discuss your particular situation with us, please don’t hesitate to reach out. Please contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with your legal needs.

Playing the Blame Game with Nursing Homes and COVID-19 Deaths

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According to a report in the Minnesota Star Tribune, they account for more than 40 percent or approximately 45,500 of the US 115,000 COVID-19 deaths, even though nursing home residents are less than one percent of the total US population. Seema Verma, the administrator for the Centers for Medicare and Medicaid Services (CMS), asserts that nursing homes following federal infection control guidelines were largely able to contain the coronavirus.

Harvard researcher David Grabowski, a member of a nonpartisan commission, advising Congress about Medicare, states that “The federal government needs to own this issue,” about the need for federal efforts to routinely test nursing home staff and residents for COVID-19 and make more protective gear available. Grabowski agrees with other advocates for the elderly that the federal government has not provided consistent virus testing and sufficient protective equipment to nursing homes, its staff, and residents.

High Risk for Elderly Care During This Election Year

In this Presidential election year, the stakes could not be higher to garner support from older voters. Partisan overtones affect the discussion and subsequent policies to guide safer nursing home outcomes from the ravages of COVID-19. The blame game is on between political parties fighting for votes and states legally protecting health care workers and facilities from coronavirus lawsuits by residents or their families.

The Trump administration deflects accountability by criticizing nursing home facilities with low federal ratings for infection control and a handful of Democratic governors, New York in particular, who mandated that nursing homes accept recovering coronavirus patients. The number two House Republican, Steve Scalise of Louisiana, states that this NY policy, and other states with similar policies, “ended up being a death sentence.” Verma echoes the nursing homes with low federal rating criticism, saying CMS has data equating low safety ratings with outbreaks of COVID-19. Several academic researchers dispute this data citing their research has found no such link. Amid the finger-pointing, shamefully, more vulnerable senior nursing home residents are dying because of the coronavirus.

Nursing Home Concerns During Coronavirus

In agreement with other academic researchers, Harvard’s David Grabowski opined that neither state policies nor proverbial bad apples among nursing homes were responsible for driving the coronavirus outbreaks. The reason is simply because of the virus’s nature, which can spread via individuals displaying no symptoms and do not feel unwell. The illness’s very nature indicates it is already spread throughout communities. Without routine testing, nursing home staff can unknowingly bring COVID-19 into a facility where it then spreads easily among frail residents living in tight quarters. Ricardo Alonso-Zaldivar of the Associated Press quotes Grabowski, “The secret weapon behind COVID is that is spreads in the absence of any symptoms,” Grabowski told lawmakers at a recent briefing. “If COVID is in a community where staff lives, it is soon to be in the facility where they work.”

Advocacy group Justice in Aging’s long-term care expert Eric Carlson cites the lack of federal coordination as impeding the ability to identify people who are infected by and require care for the coronavirus. Other advocates agree that the White House directive for the testing of all residents and staff has had an uneven response, accounting for why some facilities suffer higher rates of infection than others. The Associated Press report from the end of May 2020 concurs with these opinions reporting “White House goal on testing nursing homes unmet.”

Meanwhile, at CMS, administrator Verma believes her agency has provided necessary safety guidelines, COVID-19 reporting requirements, and Medicare payment for testing residents since the outset of the virus. She continues that states have the money required from the federal government to support the nursing home staff’s testing. Let’s hope that is the case, as the nursing home industry reports one-time testing for every resident and staffer would cost 440 million dollars.

The coronavirus pandemic is not going to go away. New spikes of cases across the country are being reported and not even considered the “second wave” of infection that many experts anticipate. Third-ranking House Democrat Representative and chairman of a special panel on the coronavirus pandemic James Clyburn of South Carolina seems to match wisdom with temperance about the finger-pointing saying that the crisis in nursing homes should not be a partisan issue. Instead, stating, “Nursing home residents have died from the coronavirus in states governed by Republicans and Democrats, in big cities and in small towns, in rural and urban communities.” Capitol Hill law and policymakers seem to be very adept at identifying problems but slow in resolving them. In the meantime, our vulnerable senior nursing home population and their families are paying the price.

We help families with loved ones in a nursing home deal with a variety of issues. If you have a loved one in a nursing home, please don’t hesitate to reach out to see how we can help. Contact our office by calling us at (318) 255-1760 and schedule an appointment today.

Telehealth Services Added to Medicare

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The Centers for Medicare & Medicaid Services (CMS) recently announced that it has increased access to Medicare telehealth services in response to the COVID-19 pandemic. This means that Medicare beneficiaries can receive more benefits from their doctors without having to travel to a healthcare facility.

The terms “telehealth” and “telemedicine” refer to the ability to exchange medical information from one site to another through electronic communication to improve a patient’s health.  With the rapid rise of COVID-19 cases, there is the urgency to expand the use of technology to help people who need routine care. Telehealth will keep vulnerable beneficiaries and those with mild symptoms in their home, but with access to the care they need by phone and video rather than requiring an office visit.

Prior to this change, Medicare would only pay for telehealth on a limited basis, and only for persons in a designated rural area. Now Medicare beneficiaries will be able to receive the following services through telehealth: common office visits, mental health counseling, and preventive health screenings. This will help keep more of the at-risk population (Medicare beneficiaries) able to visit with a doctor from home, rather than traveling to a doctor’s office or hospital which puts the beneficiary and others at risk. Telehealth visits will be treated the same as regular, in-person visits and will be paid by Medicare at the same rates.

These changes go into effect for services starting March 6, 2020, and will continue for the duration of the COVID-19 Public Health Emergency. For more information, view the fact sheet prepared by CMS.

Better access to telehealth is a big step in getting Medicare beneficiaries appropriate care in the least restrictive way. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with any questions on your planning.