Select Subcommittee Hearing Underscores Trump Administration Failures, Continued Need to Protect Nursing Home Residents and Staff

Washington, D.C. (September 21, 2022) – Today, the Select Subcommittee on the Coronavirus Crisis, chaired by Rep. James E. Clyburn, held a hearing on “Examining Long-Term Care in America: The Impact of the Coronavirus in Nursing Homes.”

“The ferocity with which the coronavirus swept through our nation’s nursing homes in 2020 exposed vulnerabilities that had been building for years.  Far too many nursing homes had inadequate staffing and poor infection control practices well before the pandemic.  These longstanding problems helped to drive outbreaks and exacerbated risks for Americans who need long-term care,” Chairman Clyburn said in his opening statement.  He also said:  “The Biden-Harris Administration has prioritized protecting the health of Americans in long-term care facilities.  In addition to conducting an historic vaccination campaign and dramatically increasing the supply of tests and PPE, the Administration has sought to institute important reforms, such as minimum staffing requirements and measures to reduce crowding inside nursing homes.  While the heightened risks that existed in 2020 have passed, risks to nursing home residents and staff still remain.  We must take further steps to address longstanding challenges in this industry.  We must increase the uptake of boosters among residents and staff to make sure that they stay protected against new coronavirus variants.”

The witnesses during today’s hearing were:  Dr. Alice Bonner, Senior Advisor for Aging at the Institute for Healthcare Improvement and the Chair of the Moving Forward Nursing Home Quality Coalition; Dr. David C. Grabowski, Professor of Health Care Policy at Harvard Medical School; Adelina Ramos, a Certified Nursing Assistant from Greenville, Rhode Island; Dr. Jasmine Travers, an Assistant Professor of Nursing at NYU Rory Meyers College of Nursing; and Daniel Arbeeny, the son of a nursing home resident.

Witnesses provided the following additional testimony:          

Longstanding Vulnerabilities Exacerbated the Devastating Impact of the Coronavirus Crisis in Nursing Homes

• Dr. Travers explained that the nursing home industry has been plagued by longstanding “structural inequities,” including “staffing shortages, inadequate pay and benefits, lack of advancement opportunities, and poor working conditions.”  
• In response to a question from Rep. Jamie Raskin about the challenges faced by nursing home workers during the pandemic, Ms. Ramos emphasized that short staffing “didn’t start with the pandemic.”  She explained that nursing homes already “had a big shortage of staff,” and “the pandemic made things worse for us in the nursing homes.”
• In response to a question by Rep. Carolyn B. Maloney about systemic low pay for nursing home workers, Dr. Grabowski stated:  “Our nurse staff are heroes.  We didn’t treat them or pay them like heroes before the pandemic, and we certainly didn’t treat them and pay them like heroes during the pandemic.”
• Ms. Ramos described her experience working at a nursing home in Rhode Island:  “We were not prepared for COVID.  Our facility already had issues, and COVID made everything worse.”

The Trump Administration’s Failed Leadership Harmed Nursing Home Residents and Staff

• Dr. Grabowski addressed the Trump Administration’s failure to follow expert advice on how to protect nursing homes:  “I served on the Trump Administration’s CMS Coronavirus Commission back in 2020. . . . We had a really strong list of recommendations.  Those recommendations were not incorporated.  The Administration said thank you and didn’t put them into practice.  I think that cost us a lot of lives at the time.”
• Ms. Ramos described the effects of early failures and how her nursing home faced severe shortages of personal protective equipment (PPE) in 2020:  “[W]e didn’t have enough PPE at the facility.  We were told we had to use the same masks for several days and we have to reuse the gowns.” 

The Biden-Harris Administration Has Taken Significant Actions to Improve Nursing Homes

• Dr. Bonner praised the White House’s February 2022 reforms to improve the safety and quality of care in the nation’s nursing homes, stating that the reforms “convey a sense of urgency to address growing gaps in care and support, that were brought into sharp focus during the pandemic.”
• Dr. Grabowski highlighted recent actions taken by the Biden-Harris Administration to address systemic problems in the nursing home industry, including that “The Biden Administration recently put a minimum staffing standard forward as part of a broader set of nursing home reforms.”  He also noted:  “Many certified nurse aides would see their hourly wages increase under the $15 minimum wage proposed by the Biden administration.”

Additional Measures—Including Pro-Worker Policies, Adequate Staffing, and Corporate Transparency—Will Further Support Staff and Protect Residents

• Dr. Grabowski explained the need for “a federal minimum staffing standard, increasing staff pay and benefits, providing opportunities for career advancement and creating a better work environment” to ensure nursing homes are able to retain staff and adequately care for residents.
• Ms. Ramos emphasized the need for better staff pay, explaining that many nursing home workers are “burnt out mentally, physically” and “our pay is so low that some of us have to work two or three jobs.”  Dr. Grabowski similarly explained:  “The best thing we can do for our residents is support our staff.  And that means paying them well, giving them strong benefits like Ms. Ramos just described with paid sick leave, and really making it a job worth having.”
• Dr. Grabowski discussed the need for regulatory reforms aimed at “increasing financial and ownership transparency,” including “collecting, auditing, and making detailed facility-level data on the finances, operation, and ownership of all nursing homes publicly available in real time in a readily usable database.”
• Looking back on her experience in 2020, Ms. Ramos testified:  “It didn’t have to be like this.  We needed Personal Protective Equipment.  We needed more training to keep ourselves and residents safe.  We needed more staff.  We pleaded with management, but nothing changed.”

“Vaccinations—including being up to date on boosters—remain our most important tool in preventing severe outcomes from the coronavirus.  Nowhere has the lifesaving impact of coronavirus vaccines been more apparent than in our nation’s nursing homes,” said Chairman Clyburn in his closing remarks.  “I urge all Americans to get vaccinated and to go out and get the updated bivalent booster as soon as they are eligible.”

Click here to read findings released today from the Select Subcommittee’s investigation into for-profit nursing homes.

Click here to read the Chairman’s opening statement in full.

Click here to watch the full hearing and read written testimonies.