Among its many effects, the COVID-19 outbreak has highlighted shortcomings in Washington’s system of nursing homes. While any pandemic is likely to disproportionately strike the aged and frail among us, the coronavirus has turned a spotlight on long-term care and the need to improve protections for some of our most vulnerable residents.
As a recent article by Columbian reporter Wyatt Stayner detailed, Vancouver Specialty and Rehabilitative Care — previously Pacific Specialty and Rehabilitative Care — in east Vancouver serves as a case study. Each year from 2017-19, state inspectors found that the facility did not have an adequate system for identifying infections and keeping them from spreading.
“These failures placed residents at risk of potential exposure to contaminants, micro-organisms and illnesses,” reads a statement of deficiencies from 2019. Since 2016, the facility has been hit with nearly $400,000 in fines from the U.S. Centers for Medicare & Medicaid Services, the highest amount in Washington.
This is not meant as a criticism of individual employees, who are working harder than ever under the pressure of a viral pandemic. Rather, it is meant to point out the importance of strong oversight from the state and the need for a financial model that allows nursing homes to best serve patients.
As of last week, nine long-term care facilities in Clark County had reported infections. Four coronavirus cases had ties to Vancouver Specialty and Rehabilitative Care, the most of any long-term care facility in Clark County; company officials said no current cases are residents, but declined to specify if they involved staff or whether patients had been hospitalized.
As reported by The Columbian: “Data shows that long-term care facilities in Washington and across the nation struggle to adhere to regulatory standards, particularly when it comes to infection control. An analysis by Kaiser Health News reported that of the nation’s nearly 9,700 nursing homes, 63 percent were cited for at least one infection-control deficiency in the last four years.”
Indeed, that can be a difficult job. With residents who often have limited mobility and often have underlying health conditions, such facilities can be fragile settings for outbreaks. Many nursing homes also are hampered by the financial realities of the industry.
Nearly 70 percent of patients in skilled nursing homes rely on state Medicaid, an assistance program for low-income individuals. But Medicaid funding over the years has not kept up with inflation or Washington’s increased minimum wage, which affects many nursing home employees. “The state has not prioritized this, and a lot of legislators don’t understand the stress nursing homes are under,” state Rep. Michelle Caldier, R-Port Orchard, told The (Tacoma) News Tribune.
Meanwhile, The News Tribune reported, 20 of the state’s 215 nursing homes have closed since 2017, adding strain to the system.
Last year, the Legislature created the nation’s first public Long Term Care insurance system, funneling a payroll deduction tax into a trust fund. The program is expected to save the state’s Medicaid program $34 million over the next five years. This year, lawmakers approved a slight increase to the Medicaid reimbursement rate, designed to ease the financial stress on nursing homes.
Hopefully, these changes will help address shortcomings in the system and improve care for vulnerable people. After working long careers and raising families and providing contributions that have made Washington the state that it is, they deserve it.
