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Nursing home reform needed

Newsday

Over the last year, there have been many stories like Carole Major’s, the former licensed practical nurse from Ronkonkoma who died after contracting COVID-19 in a local nursing home. Except Major, 78, entered the facility for rehab treatment just this January, and died late last month.

Clearly, the scrutiny on nursing home care from the COVID-19 crisis should not wane. Significant reforms are needed — to the way nursing homes are managed and operated, to the way money is spent and how the homes are overseen, to the importance of making public key details about facility ownership, management and infection control, to how regulations are enforced, and most important, to how everything translates into better patient care.

State lawmakers can make that happen right away. It’s smart, for instance, to require that at least 70 percent of a nursing home’s total revenue go to direct patient care, and within that, that 40 percent of the total goes to staffing. Instituting a minimum number of hours of care, per-patient, per-day, is also important, though that will require state funds to support it.

Mandating audits on infection control, and posting results online, so families know exactly how their loved one’s home is performing, also will be important.

But the attention on nursing homes must also deal with more immediate concerns, including the continued impact of the pandemic on staff, and residents like Major. State officials said there’s been some hope on that front: COVID cases in nursing homes have dropped more than 70 percent from the post-holiday highs in January.

But concerns remain, particularly in terms of the low rates of vaccination among nursing home facility staff. Within the federal program that vaccinated nursing home staff at the facilities, only 47 percent of nursing home staff on Long Island were vaccinated. It’s unclear how many more have been vaccinated since. Every nursing home operator should post its percentages of vaccinated staff, and update them daily, so families and others know. If they won’t do that on their own, the state should require it.

State officials have indicated that vaccinating nursing home staff remains a priority. So, wherever possible, the state should create additional opportunities for staff to be vaccinated at or near the facilities. While union leaders have tried to encourage vaccination, they, too, need to do more to push the message or even incentivize vaccination. Newly arriving vulnerable residents should not be worried that they’re going to get COVID-19 from a staff member unwilling to get a shot.

The larger and longer-term issues are far more difficult to solve. A commission is needed to analyze how many beds are needed statewide, evaluate how homes are funded, look at individual homes’ best practices, and study how other states manage and oversee the industry differently. Its recommendations must be part of any reform effort. The significant steps state officials can take now are necessary, but a larger rethinking is key to improving care.

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