Baker accused of misplaced COVID-19 priorities

Two leading officials in the state’s nursing home industry said on The Codcast that the Baker administration focused too much attention in the early stages of the COVID-19 crisis on hospitals and not enough on long-term care facilities.

“The state has done a tremendous job of focusing on hospital surge and doing all we can through social distancing and tracing methods to really try to protect our communities, but where the virus is most severe is in our long-term care facilities,” said Tara Gregorio, president of the Massachusetts Senior Care Association. “Clearly we do need to redouble our focus relative to the crisis in nursing facilities.”

Rich Bane, the president of BaneCare Management, which operates 11 nursing homes and two assisted living facilities in Massachusetts, echoed that sentiment. “There’s a sports metaphor here,” he said. “The state was guarding the wrong man early on.”

One possible sign of the state’s slow grasp of the nursing home situation was its data gathering. It wasn’t until April 2, when the total number of COVID-19 cases reached 8,966 and the total number of deaths hit 154 that the state started to report on the situation at nursing homes. Initially, the state only released information on the number of positive tests at long-term care facilities and the number of facilities with at least one COVID-19 case.

It took another eight days before the state started releasing information on the number of deaths at long-term care facilities, a statistic that made clear the depth of the problem. On April 10, the state reported 247 deaths at long-term care facilities, or 41 percent of the total across the state. Nine days later the number had risen to 884, or 52 percent of the state’s total.

The delay in releasing deaths may have been a failure to collect that information. Marylou Sudders, the secretary of health and human services, said on April 7 that the state had the data in hand and would make it publicly available that afternoon. But the information wasn’t released until four days later.

Gregorio said long-term care facilities weren’t actually required to submit the death data to the state until April 6. “On the one hand, we had been reporting through the MassMAP system incidents of COVID positive or COVID-suspect cases, but it really wasn’t until [April 6] that we received a directive from the state to begin reporting through their [Health Care Facility Reporting System] on COVID deaths or COVID-related deaths,” Gregorio said.

Sudders has promised more information on long-term care facilities this week. She was vague about what would be released, but indicated the state may start breaking down COVID-19 information by facility, which would allow the public to see whether cases are spreading throughout a community or concentrated in long-term care facilities. Some facilities already release that information. Bane announced on April 13 four deaths at his company’s facilities and on Sunday broke down positive cases by residents (146) and staff (65).

Bane said it’s not surprising that nursing homes have been hard hit by COVID-19. “When you think about it, it’s pretty intuitive,” he said. “All we’re hearing about is the importance of social distancing as the way to mitigate the virus, yet what happens in nursing homes is the exact opposite of social distancing. Our direct care staff provides hands-on care, intimate care, activities of daily living for frail elders who can no longer be cared for at home. So we are actually doing the exact opposite of what you’re supposed to do in the face of a contagion like COVID-19.”

Gregorio came on the Codcast a year ago to talk about the financial plight of the nursing home industry in Massachusetts. She said not much has changed since then – 70 percent of nursing homes are losing money – and the situation has worsened with COVID-19.

She said the Baker administration is stepping up with testing and personal protection equipment, but for nursing homes a shortage of employees is the big problem.

Gregorio said the job vacancy rate in the industry was 17 percent on March 1, which means about 5,600 direct care positions were empty. Now, she said, the vacancy rate is 40 percent, or 12,000 positions. And as the National Guard conducts more and more COVID-19 tests at facilities, the fear among staff rises and more leave. “The more we test the more we have a staffing problem,” she said.

Bane said the average starting wage rate for certified nursing assistants is $13 an hour and licensed nurses are in the high $20 to low $30 range. “We’re having to compete against hospitals that are paying $35, $40, $50 an hour for those nurses,” he said.

Gregorio said nursing home workers need to be paid a “hero’s wage” during the crisis – a doubling of what they currently receive. Bane said he is already paying more, but the compensation he receives from Medicaid doesn’t cover the cost. Gregorio said many nursing homes aren’t paying other bills, most of which will come due in June and July.

Both Bane and Gregorio said they expect COVID-19 to linger longer in long-term care facilities than in the rest of society. Gregorio said cases will continue to surface until a vaccine for COVID-19 is developed.

“It doesn’t have to be the worst-case scenario,” she said. “We don’t need to lose 10 percent of our residents to this deadly contagious virus. And the way that we do it is by investing in testing, PPE, and a hero’s wage.”

BRUCE MOH


BEACON HILL

Lawmakers on Friday sent Gov. Charlie Baker a bill banning non-essential evictions and foreclosures. (Associated Press)

Gov. Charlie Baker signs a bill extending liability protections for health care workers during the coronavirus pandemic. (MassLive)

The state has emerged a national hot spot that’s on the radar of leaders in Washington. (Boston Globe)

MUNICIPAL MATTERS

Fourth in a CommonWealth series on municipal leaders: In hard-hit Chelsea, City Manager Tom Ambrosino takes a team approach to fighting COVID-19.

Brockton city councilors will debate higher rates and new fees to use the city’s water and sewer systems. (The Enterprise) 

CORONAVIRUS

WBUR takes a look at the results so far from the state’s track and trace effort. The infected have fewer contacts than expected but it’s not easy getting those contacts to pick up the phone and learn their options. Many think the calls are spam.

MassLive takes a look back at how much has changed in the one month since Massachusetts’ first coronavirus death.

A group of doctors and nurses dubbed the “Happiness Committee” at Massachusetts General Hospital is asking the public to donate cell phone chargers for COVID-19 patients to stay connected with loved ones. (WGBH)

About 100 people gathered Sunday in Bourne in protest of coronavirus-related restrictions, urging the governor and public officials to end the shutdown. (Cape Cod Times) 

HEALTH/HEALTH CARE

More COVID-19 deaths are now occurring in long-term care facilities than hospitals and elsewhere. (CommonWealth) Rep. James O’Day says it’s time for the state to help nursing homes. (CommonWealth) Ten deaths and 58 residents test positive at a Raynham nursing home. (Taunton Gazette) The head of the US Centers for Disease Control ups reporting requirements for nursing homes, calling them “ground zero for COVID-19.” (NPR) Discharging COVID-19 patients from hospitals to nursing homes is called “a recipe for disaster.” (NPR)

Health officials warn of a second wave of the virus. (Gloucester Daily Times)

There are 46 homeless COVID-19 patients housed in a field hospital at Worcester’s DCU Center. (Telegram & Gazette)

Though children represent a demographic that has been mostly spared from the pandemic, there are a small number of pediatric hospitalizations with COVID-19. (Boston Globe)

A Baystate Health doctor throws back the curtain on a major covert effort – involving a secret warehouse, disguised trucks and questioning by FBI agents – to obtain personal protective equipment. (MassLive)

WASHINGTON/NATIONAL/INTERNATIONAL

President Trump is stoking the anti-government protests against stay-at-home orders from governors. (New York Times)

ELECTIONS

ICYMI: The Supreme Judicial Court halves signature requirements for running for election. (CommonWealth)

BUSINESS/ECONOMY

Sharon Block and Mike Firestone say we need to take a tough stance on worker misclassification: Don’t let “Big Gig” game the system. (CommonWealth)

Equifax is paying Massachusetts $18.2 million as part of a settlement related to a 2017 data breach.(CommonWealth)

Some experts say the pandemic will spur a return of domestic manufacturing. (Boston Herald)

With screens dark, movie theaters are struggling to survive. (Telegram & Gazette)

EDUCATION

Central Massachusetts school officials worry about whether students and families will feel ready to return to school in two weeks. (Telegram & Gazette)

Needham middle school teacher Stephen Guerriero says it’s time to incorporate the story LGBTQ people and other marginalized groups into the state’s school curriculum. (CommonWealth)

The school interruption has been particularly destabilizing for high school seniors with disabilities. (Boston Globe)

ARTS/CULTURE

The heads of the aquarium, zoo, and the science and children’s museums say the COVID-19 crisis is highlighting the importance of science in our lives. (CommonWealth)

TRANSPORTATION

Massachusetts drivers have cut their highway trips by 68 percent compared to this time last year. (State House News Service)

Even though it’s scary at a time like this, Samarth Gupta urges the state and the MBTA to use debt financing to expand and improve the transit system. (CommonWealth)

The few remaining MBTA riders, many lower-wage workers still on the job, approach their commutes with great trepidation. (Boston Globe)

ENERGY/ENVIRONMENT

Sens. Elizabeth Warren and Ed Markey are asking Enbridge, the company currently building a natural gas compressor station in Weymouth, what steps it is taking to mitigate potential coronavirus spread risks to workers and the community. (Patriot Ledger)

CRIMINAL JUSTICE/COURTS

A new lawsuit from Prisoners’ Legal Services seeks the release of sentenced prisoners to house arrest to stem the spread of coronavirus. (Commonwealth)

An accused fentanyl dealer who was released by a judge because he tested positive for coronavirus is living with his mother at a senior citizen apartment building in Salem. (Boston Herald)

Coronavirus is causing major upheaval in the court system. (MassLive)

MEDIA

The majority of the Boston Herald’s workforce will be furloughed in the coming weeks by parent company Media News Group. (Commonwealth)

National Public Radio warns of steep cuts as funding dries up during the COVID-19 pandemic. (Wall Street Journal)