Senate Told to Find New Approaches for Nursing Homes Hit With Coronavirus

WASHINGTON – The U.S. Senate made a first step Thursday toward new legislation intended specifically to protect elderly people from the ravages of coronavirus.

The Senate Special Committee on Aging listened to medical experts’ opinions on measures needed to help the elderly, who represent nearly 80% of the fatalities from the disease.

More than 26,000 of them have been residents of nursing homes or other assisted living facilities. Meanwhile, the nation’s total death toll from the virus is creeping toward 100,000.

“Nursing homes have become the epicenter of the crisis,” said Sen. Elizabeth Warren, a Massachusetts Democrat who is mourning the recent death of her older brother from coronavirus.

One option Congress is considering would direct more money to home health care of the elderly.

“As we all know, the crisis has uncovered limitations to hospital and emergency room bed capacity and has also uncovered the potential challenges of nursing facility-based care, highlighting the importance of a strong home care option,” said Steven H. Landers, president of VNA Health Group.

New Jersey-based VNA is one the nation’s largest nonprofit providers of home health, hospice and community-based care.

A modern addition to home health care that is only starting to be realized is telehealth, Landers said.

With telehealth, patients communicate with doctors online and by telephone but stay at home. Either by themselves or with the assistance of other persons and equipment, doctors often can get the patients’ vital signs and diagnose their symptoms from miles away.

“The remote monitoring and virtual assessments of the vital signs, oxygen levels and other symptoms of COVID-19 home health patients has been critical to them safely remaining at home,” Landers told the Senate committee.

However, funding to continue telehealth has been sparse, he said.

“I specifically recommend addressing the lack of reimbursement for home health agency telehealth services and extending indefinitely the emergency measure that allows physicians and other providers to perform the home health face-to-face encounter via telehealth,” Landers said.

The Senate hearing was held one day after the Government Accountability Office reported that about 40% of nursing homes were cited for infection control problems before the pandemic.

The nursing home industry is asking Congress for $10 billion as they struggle to survive financially with strained resources. The $2 trillion coronavirus relief package approved in March includes $200 million to help the Centers for Medicare and Medicaid with infection prevention in nursing homes.

Several senators and witnesses at the hearing expressed optimism that the rapid pace of vaccine development and use of the antiviral drug remdesivir would bring relief from coronavirus soon.

Mark J. Mulligan, who directs vaccine development at New York’s Langone Vaccine Center, said treating the elderly might require unique strategies because their biology changes as they age.

The strategies might include higher doses of medicines or vaccines, Mulligan said.

“Perhaps we can infuse the antibodies” directly into their bodies, he said.

R. Tamara Konetzka, a professor of Health Services Research at the University of Chicago, suggested weekly testing for coronavirus at nursing homes and collecting more data about spread of the disease among the elderly.

“We need to know where to direct resources,” she said.