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Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Sens. Steve Daines (R-Mont.) and Martha McSally (R-Ariz.) introduced the Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020, which will improve existing programs to protect older Americans while also providing help to nursing homes in light of the COVID-19 pandemic that has posed serious problems for these facilities.

“This virus has taken a serious toll on older Americans and caregivers. The first major outbreak of COVID-19 and a significant number of fatalities have occurred in nursing homes. This bill will provide resources and ramp up accountability to curb the spread and effects of the pandemic. It’ll also renew several programs already in effect that protect seniors from abuse and neglect,” Grassley said. “I plan to work toward this bill’s inclusion in any additional coronavirus relief legislation that may be considered.”

“I’m grateful for the important work being done by Montana’s nursing homes and assisted living facilities who care for and help keep our most vulnerable populations safe,” Daines said. “This bill is critical to ensuring that our senior care facilities have the resources necessary to continue serving and keeping Montana’s seniors safe especially during the ongoing COVID-19 pandemic.”

The legislation includes several provisions to help nursing homes facing COVID-19 outbreaks, including the establishment of specialty regional “strike teams” that can rapidly respond to new outbreaks and extend COVID-19 related reporting requirements through the end of 2020. The bill calls on states receiving federal relief assistance to devote some funding to televistation programs, so nursing home residents aren’t isolated from family amid the stresses of the pandemic.

It also renews and reauthorizes funding for several programs enacted in the Elder Justice Act of 2009, and boosts transparency and accountability measures for underperforming nursing homes.

The Emergency Support for Nursing Homes and Elder Justice Reform Act is endorsed by the Elder Justice Coalition, National Adult Protective Services Association, Alzheimer’s Impact Movement and Alzheimer’s Association.

More information:

Introduction of this bill follows last month’s World Elder Abuse Awareness Day (June 15, 2020), which was established to highlight the widespread problems of abuse, neglect and exploitation of seniors. Grassley’s resolution designating June 15 as World Elder Abuse Awareness Day was unanimously agreed to in the Senate.

Grassley also entered the following prepared statement into the Congressional Record.

Statement for the Record

Senator Chuck Grassley

Chairman, Senate Finance Committee

Introduction of the Emergency Support for Nursing Homes and Elder Justice Reform Act Of 2020

July 2, 2020

Mr. President, today I am introducing legislation to better protect older Americans, a population that’s suffered, more acutely than most, from the brutal impacts of the COVID-19 pandemic. 

This bill, on which I’ve been working with my colleagues on both sides of the aisle for several months, makes emergency relief available for personal protective equipment, diagnostic testing, and strike teams for nursing homes in crisis during this national emergency. There is broad agreement on the need to ensure that these homes and assisted living facilities have the resources they need to safely and effectively care for their elderly residents.

This is an area in which I’ve worked for decades. My purpose for introducing the bill today is twofold: first, I want to confirm that this issue, nursing home relief, is a top priority for all Republicans, contrary to the statements by some of my colleagues across the aisle yesterday. I’ve asked several of the Senators who spoke on the floor yesterday, including Senator Casey, to work with me on a bipartisan package in this area, and so of course I’m disappointed that they’ve decided instead to pursue a partisan approach.

Second, my hope is that version of this bill can be included in the next relief package our chamber adopts. That’s why I’m circulating this proposal now, to give my colleagues in this chamber an opportunity to contribute input. I want to thank Senators Daines and McSally for their cosponsorship. I also want to thank the Elder Justice Coalition, which is comprised of hundreds of elder abuse advocacy groups, for its endorsement. The National Adult Protective Services Association, the Alzheimer’s Impact Movement, and the Alzheimer’s Association, among others, also have endorsed this legislation.

We’ve all seen the news articles about the devastation this pandemic has caused in nursing homes all across the country. With over 54,000 deaths in nursing homes now linked to the coronavirus, such facilities remain hotspots for the coronavirus. One in five nursing homes nationwide have reported cases of the coronavirus. And, according to an article in yesterday’s New York Times, roughly 40 percent of all deaths attributable to this virus have occurred in long-term care facilities.

Some of our colleagues have argued that the fault for every one of these fatalities lies entirely with the Trump Administration. That’s far too simplistic and, quite frankly, partisan an explanation. It’s also just incorrect, as government watchdog agencies have for many years described shortfalls in nursing home oversight. These shortfalls persisted over multiple administrations. And, of course, oversight of nursing facilities is a shared Federal-State responsibility, with States playing the primary role in licensing and inspecting these facilities.

A less partisan, more complex, and far more meaningful answer is that COVID-19 only exacerbated problems with which nursing homes struggled for many years prior to the pandemic. Having worked on this area for many years, including as Aging Chairman, I am acutely aware of these shortfalls.

First, as is evident from nonpartisan reports by the Government Accountability Office over the last two decades, there’s been a slow, but consistent downward decline in the quality of care provided by many nursing facilities over the years. These shortfalls, including infection control deficiencies and inadequate staffing, played a huge role in this year’s transmission of the virus in nursing homes.

For example, as noted last month by GAO, 82 percent of all nursing homes have been cited at least once in a recent four-year period for infection control issues. Examples of these deficiencies include not wearing masks or other personal protective equipment and inadequate handwashing. Infection control issues were, in fact, the most common deficiency cited in nursing homes. About half of nursing homes had persistent problems in this area and were cited more than once across multiple years.

Second, this dire situation in nursing homes during the emergency is due, in part, to the vulnerabilities of nursing home residents. These typically are elderly, frail individuals. Many have preexisting conditions that make them more susceptible than the young, on average, to the most brutal effects of the coronavirus. This has been widely documented.

Third, nursing home fatalities during this pandemic are also due in part to staffing shortfalls at many nursing facilities, coupled with the close quarters in which most residents live. As underscored by researchers and the media, nursing homes have struggled with staffing issues for years. For example, as noted by the Pittsburgh Post Gazette, “Pennsylvania’s already low minimum staffing requirements, long criticized as “totally unsafe,” were exacerbated by the pandemic.” Pennsylvania reportedly has the seventh highest death rate for residents of long-term care facilities, with 69 percent of the state’s COVID-19 fatalities attributable to nursing and personal care facilities. 

Too many lives have already been lost to the coronavirus, and without bold action many more will be lost. In my home state of Iowa, more than half the fatalities due to this virus have occurred in nursing homes or other long-term care facilities.

That’s why we’re introducing this legislation today. It will give facilities the resources they need to protect personnel and workers, curbing the further spread of the virus. The requirements in our legislation, which will not take effect unless emergency funding is attached, ensure that states will devote additional resources to this issue, at levels determined by the Centers for Disease Control and Prevention, in consultation with the Federal Emergency Management Agency and the Department of Health and Human Services (HHS).

Among the bill’s major provisions, which apply mainly to nursing homes participating in the Medicare and Medicaid programs, is the requirement that they report coronavirus cases and fatalities for the entire 2020 calendar year to the Centers for Disease Control and Prevention.

The bill also ensures that States receiving Federal relief assistance during the emergency period must devote some of the emergency funding to statewide or regional strike teams that can promptly respond to COVID–19-related crises in nursing homes that are overwhelmed by the pandemic.

It ensures Federal relief assistance will be devoted to televisitation. This provision will ensure that nursing home and assisted living facility residents, who are isolated during the emergency, can communicate with outside family and friends.

As the former Aging Committee chairman and as a member and chairman of the Finance Committee, I’ve long sounded the alarm about the many challenges that nursing homes face. Unfortunately, it has taken a pandemic of historic proportions to elevate these issues to national attention.

Last year, as Chairman of the Senate Finance Committee, I convened two hearings that highlighted abuse and neglect in nursing homes. The reforms in this legislation will improve oversight of these facilities and give families peace of mind that their loved ones will be treated with dignity and respect. To that end, this legislation also extends funding for programs, such as elder abuse forensic centers and long-term care ombudsman training, established under the Elder Justice Act of 2010.

The bill also provides that adult protective services agencies across the country can receive $60 million in emergency funding to investigate increased abuse of senior citizens. This provision recognizes that social isolation only increases the risks of abuse, and some senior citizens may be at greater risk during this emergency period due to the issuance of stay-at-home orders.

Finally, this bill includes nursing home reform provisions that the HHS Inspector General recommended or that respond to issues raised at the two nursing home hearings we held in 2019. I urge all of my colleagues to cosponsor this critical legislation.