‘Where else can they call home?’ COVID-19 spotlights tragedy of Kansas nursing homes

It’s an unmitigated scandal what COVID-19 is doing to our senior citizens in nursing homes. No one should rest until the current tragedy is abated and future ones avoided.

As residents die and suffer in isolation, it’s clear the pandemic has not just taken residents’ lives and cruelly kept them from their families, but also has illuminated and exacerbated the unforgivable flaws already in the system.

The long-term care system is ill-suited and ill-supported to withstand an outbreak of disease. How could society have done such a poor job protecting our most vulnerable?

Nursing home residents in Kansas are under renewed assault from COVID-19, with state health officials reporting a horrifying 250 long-term care clusters.

One of the worst is at Andbe Nursing home in Norton, where 10 residents have recently died following the infection of all 62 patients, as well as some staff. The facility didn’t quarantine coronavirus-positive residents, and inspectors found hopelessly belated testing, communal dining and multiple staff not wearing masks.

Worse yet, the home had been cited for “immediate jeopardy” as early as May for failure to follow COVID-19 protocols. The home has now been kicked out of the Medicare program.

‘Skimming by,’ visitors reporting no mask-wearing

Alas, Andbe is not alone in its failures. Five or more homes were found to have insufficient COVID-19 protocols from May to September, and reports are trickling in of staff and residents at other facilities not wearing masks.

“I had one family member tell me last week he was at an assisted living, and no one had a mask on while he was there visiting on a Saturday,” Sue Schuster, a Kansas regional long-term care ombudsman, told The Star. “He was aware that another building in town had active COVID in their building, so that shook him pretty badly.”

Schuster says the problems are particularly acute in nursing homes “that were ‘skimming by’ with sloppy systems and processes and too few staff on a regular basis.”

To be fair, even the best nursing homes have been walloped by the coronavirus, and they deserve our support rather than our scorn. And on its best day, staffing is a herculean challenge across the industry, Schuster says. During the pandemic, with already small staffs cut by illness — and no one out there to replace them — administrators are pitching in, and direct-care staff are working hellish hours. With testing needs and special rooms required for socially distanced visits in the cold months, the facilities could actually use more staff than usual.

Even administrators are increasingly throwing in the towel, either retiring or finding a new line of work, says Debra Harmon Zehr, president/CEO of LeadingAge Kansas, an association of 160 not-for-profit aging services providers.

“I get calls like that every week. Every week. Multiple calls,” she says.

State Sen. Molly Baumgardner also suggests a look at how the state has performed during the pandemic. She says infection control training and personal protective equipment have lagged at long-term care facilities, and at one point, the state appears to have required them to accept COVID-positive residents.

The idea of triage, Baumgardner argues, is to tend to the most at-risk first. Why weren’t nursing homes at the front of that line?

“We’ve known from day one when COVID hit the state of Kansas that our elderly were the most vulnerable,” she says.

Residents in close quarters 24/7

Keeping nursing home residents safe is especially challenging because staff and visiting vendors are out in the community living their lives. Plus, a nursing home, by design, encapsulates pretty much everything we’re not supposed to do during a pandemic: grouping high-risk citizens in close quarters 24/7, amid the most intimate of care-giving.

“I don’t know that you can stop all infections,” Zehr says. And once the coronavirus is inside a nursing home, it spreads quickly.

When visits are permitted — it’s inhumane to keep nursing home residents in total isolation for so many months at a time — it’s difficult for family members to turn down a request for a hug, particularly when the resident may not be capable of understanding the circumstances of the pandemic.

That’s all the more reason, though, to take the strictest of precautions.

And to make sure this never happens again — which means an all-hands-on-deck review, at the state and county and community level, of how we got here with nursing homes and how to get where we need to be. Is it a lack of laws and regulations? A lack of enforcement? Are pay and training for staff adequate? (Hint: they’re not.) How can turnover be reduced? Shouldn’t nursing homes be at least as well-resourced as hospitals? One area of immediate need, notes Zehr, is crisis emergency staffing before and during outbreaks.

In the big picture, there must be an honest and uncomfortable top-to-bottom review of long-term care facilities and their oversight. As is now clear, lives are at stake.

“I hope that this is an awakening to what our priorities are,” says Linda MowBray, president and CEO of the Kansas Health Care Association representing 225 long-term care providers. “I just don’t think that we give our elders the place that they deserve — and that’s our full attention.”

“If we learn anything out of this pandemic, it is we desperately need to find ways to encourage a lot more workers into the health care profession at the direct care level,” says Schuster. “We need them everywhere.”

“It really does require everyone to come together to help these Kansans,” Baumgardner said. “They are a part of our communities. We should respect and allow them the dignity to live in an environment that is safe. And we’ve failed them on that.

“Where else can they call home?”