Sudders: Nursing homes still work in progress

Death toll surpasses industry’s worst-case scenario

AS THE STATE’S OVERALL COVID-19 numbers continue to trend in a good direction, a top Baker administration official said on Tuesday that addressing the serious problems faced by nursing homes remains a work in progress.

Residents and staff at long-term care facilities across Massachusetts currently account for 21 percent of the state’s COVID-19 cases and 61 percent of the fatalities. The numbers exceed a worst-case scenario feared by the industry just over a month ago.

What caused fatalities at these facilities to rise so high has become one of the major questions facing state policymakers. It is also why the Baker administration is moving slowly in allowing family visits, probably outdoors, to senior care facilities. Officials said visits would not resume for at least two weeks. “It’s a complicated issue, a lot of psychological benefit but big concerns about issues associated with the virus,” said Gov. Charlie Baker at a State House press conference.

Marylou Sudders, the governor’s secretary of health and human services, said  issues surrounding infection control, personal protection equipment, and staffing were a problem at long-term care facilities before the COVID-19 pandemic began and have remained a problem during the pandemic.

”We are in a process of really understanding what the issues are in nursing homes and putting the processes in place to stabilize – but not just stabilize but to move forward. So I think this is very much a work in progress,” Sudders said.

Last week, the state reported that 37 percent of 360 audited nursing homes failed to pass a 28-point infection control inspection. One point was awarded for each of the 28 items on the checklist, with those facilities scoring 24 or more points passing, those scoring 20 to 24 passing but requiring an additional inspection, and those scoring under 20 or those failing one of the six core requirements failing.

According to the state Department of Public Health, 228 facilities passed. The remaining 132 failed — 119 of them had scores of 20 or above but failed one of the core requirements and 13 scored less than 20.

Sudders said those facilities that failed are now being audited again. Results of those audits will be available next week, but Sudders indicated the early results from a third of them indicated significant improvement, particularly on infection control and personal protection equipment.

The Holyoke and Chelsea Soldiers’ Homes, which have gained a lot of notoriety for veteran fatalities during the COVID-19 pandemic, were not included in the audits. The Holyoke home is the focus of several ongoing investigations, including one by a former prosecutor retained by the Baker administration to look into what went wrong. Gov. Charlie Baker said Tuesday that the report should be released soon, and he will wait until then before commenting.

The number of deaths at long-term care facilities is closing in on 4,000, which would be a very grim milestone.

Tara Gregorio, the president of the Massachusetts Senior Care Association, warned on April 13 that deaths would spiral upward unless state leaders quickly ramped up testing of residents and staff, delivered more personal protection equipment, and funneled an additional $130 million a month to the industry. At the time, 378 residents and staff at long-term care facilities had died of COVID-19.

Gregorio said her organization’s modeling indicated the most likely scenario would yield 12,500 infections and 1,140 deaths at nursing homes. But she said any delays in providing additional funding, testing, and personal protection equipment could up the projections to a worst-case scenario of 19,000 infections and 3,800 deaths.

The Baker administration quickly stepped up its mobile testing of long-term care facilities using the National Guard and delivered more personal protection equipment. A one-time infusion of $130 million was announced on April 27, with none of the money released to nursing homes until last week.

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Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

As of Tuesday, the COVID-19 situation at nursing homes had exceeded the Senior Care Association’s worst-case scenario. There have been 19,919 infections and 3,963 deaths. On Tuesday, 39 COVID-19 deaths occurred in nursing homes and 18 everywhere else.

Gregorio, the president of the Senior Care Association, could not be reached for comment.