Susan Jaffe

CMS Warns of COVID-19 Spike in Nursing Homes

Medicare chief says “significant deficiencies in infection control practices” in nursing homes have doubled weekly COVID-19 cases, but “this isn’t a time of fines and being punitive.”

By Susan Jaffe | Contributing Writer | MedPageToday | August 20, 2020

The Centers for Medicare & Medicaid Services (CMS) wants nursing homes to ramp up efforts to control COVID-19 inside facilities after the number of residents infected with the highly contagious virus has reached a record high, and as new deaths have started rising once again.

In the early spring, the number of virus cases in nursing homes was about 11,000 a week, which dropped to 6,319 cases by the end of June, CMS Aministrator Seema Verma told facility operators last week in a conference call. But CMS strike force teams have found “significant deficiencies in infection control practices” that have pushed up weekly cases to about 12,000 by the end of July, she said. “And we’re seeing an uptick unfortunately in the losses.”

Residents in about half the nation’s nursing homes have been infected, Verma told MedPage Today in an exclusive interview on Tuesday. [Continued here.]

CMS, Medicare, Medicare costs

House Committee Approves Bill to Ease Medicare Part B Enrollment

Seniors would be notified about eligibility to avoid late fees, coverage gap

By Susan Jaffe | Contributing Writer | MedPageToday | July 15, 2020

A House committee unanimously approved legislation Wednesday that would make changes for the first time in 50 years to the complex rules for enrolling in Medicare’s Part B, which covers doctor visits and other outpatient care.

Currently, seniors who don’t get Part B when they first become eligible for Medicare pay permanent, recurring late enrollment penalties and can only sign up during the first 3 months of the year for coverage that begins July 1, unless they qualify for an exception. To make matters worse, they cannot buy other health insurance during their months-long wait. [Continued here.]

HHS, The Lancet

US Supreme Court upholds abortion rights, for now

Volume 396, Number 10244

11 July 2020

WORLD REPORT The court’s decision means that Louisiana’s three abortion clinics will remain open. Susan Jaffe reports.

The US Supreme Court delivered the Trump administration’s third defeat in as many weeks when it overturned a Louisiana law requiring physicians who provide abortions to have local hospital-admitting privileges.

In an opinion written by Justice Stephen Breyer, the court declared on June 29 that “enforcing the admitting privileges requirement would drastically reduce the number and geographic distribution of abortion providers, making it impossible for many women to obtain a safe, legal abortion in the State and imposing substantial obstacles on those who could”. [Continued here.]

Affordable Care Act, HHS, The Lancet

LGBTQ discrimination in US health care under scrutiny

Volume 395 Number 10242

27 June 2020

WORLD REPORT A US Supreme Court ruling could undermine the Trump Administration’s plan to roll back some protections against sex discrimination. Susan Jaffe reports.

The Trump administration suffered a major defeat last week a major defeat last week in the US Supreme Court, which could undermine its attempt to scrap protections under the Affordable Care Act (ACA) against sex discrimination. In a landmark decision on June 15, the court ruled that the Civil Rights Act protects gay and transgender workers from discrimination by their employers. But days later, Trump Administration officials at the Department of Health and Human Services (HHS) finalised a more permissive standard for discrimination in health care. [Continued here.]

CMS, HHS, Long term care

Whether By Luck Or Safety Protocols, Some Nursing Homes Remain COVID-19 Free

BY SUSAN JAFFE | CONNECTICUT HEALTH INVESTIGATIVE TEAM | JUNE 15,2020

The coronavirus has decimated many of the nation’s nursing homes, and elderly, chronically ill residents of these facilities account for 64% of the state’s 4,201 death toll. They are roughly 100 times more likely to die of the virus than other people in the state.

So, the fact that some 41 of Connecticut’s 214 nursing homes have managed to keep out the virus, according to an analysis by C-HIT, is both remarkable and mystifying. Did they just get lucky?

This article also ran on Connecticut Public Radio.

Administrators at several COVID-19-free facilities use the word “fortunate” to describe a situation they acknowledge could change at any time. [Continued here, with map and table of COVID-19 free nursing homes.]

CMS, Long term care, Medicare

Hundreds Died of COVID at NYC Nursing Homes With Spotless Infection Inspections

By Susan Jaffe | THE CITY | May 27, 2020

More than 600 residents have died from COVID-19 at 25 New York City nursing homes that received clean bills of health for controlling the spread of infections, state Department of Health inspection reports obtained by THE CITY show.

Those facilities include homes with some of the highest coronavirus death tolls in the nation — including the Sapphire Center for Rehabilitation and Nursing in Flushing, which reports 54 residents died of confirmed or presumed COVID….

At the Franklin Center for Rehabilitation and Nursing, also in Flushing, 60 residents — nearly one in five — succumbed to the virus. Its May 4 inspection report found no problems.

Also passing its May 11 infection-control inspection was New York State Veterans Home in St. Albans, Queens. Staff there previously told THE CITY that the state Health Department-run home failed to separate COVID-positive and uninfected residents, something that was a violation at other facilities….

“It’s very shocking that at the apex of this pandemic, our inspectors went in and reported that that there’s nothing out of the ordinary when it’s clear that the infection rate had spread,” said Assemblymember Ron Kim (D-Queens), whose district includes Sapphire and the Franklin Center. [continued here].

CMS, Long term care

As Congress Weighs COVID Liability Protections, States Shield Health Providers

By Susan Jaffe | Kaiser Health News | May 14, 2020 | This story also ran on

Coronavirus patients and their families who believe a doctor, nurse, hospital or other provider made serious mistakes during their care may face a new hurdle if they try to file medical malpractice lawsuits.

Under pressure from health provider organizations, governors in Connecticut, Maryland, Illinois and several other states have ordered that most providers be shielded from civil ― and, in some cases, criminal— lawsuits over medical treatment during the C OVID-19 health emergency. In New York and New Jersey, immunity is now part of state law….

Some legal experts and seniors’ advocates worry that the state immunity guarantees go too far, leaving patients with no way to hold providers accountable. Supporters argue that health care providers and facilities deserve protection from lawsuits as they battle a deadly virus during an unprecedented public health emergency. [Continued at Kaiser Health News and Daily Beast. ]

CMS, Federal agencies, Long term care

Nursing Home Watchdogs Scarce At NYC Facilities As Hundreds Die Within

CLOSED DOORS | THE CITY | April 23, 2020

By Susan Jaffe

Eyes and ears usually trained on New York’s nursing homes and adult care facilities have been nearly locked out as the coronavirus has claimed the lives of more than 3,500 residents statewide.

Almost entirely out of the picture are nursing home inspectors,employed by the state Department of Health and

coordinated by the federal government, who are responsible for ensuring that the facilities comply with federal health and safety requirements.

“Nursing facilities are essentially free of public scrutiny right now, at a time when scrutiny is more important than ever,” said Susan Dooha, executive director of the Center for Independence of the Disabled in New York [continued here].

Drugs, FDA, Global Health, The Lancet

Federal Regulators split on antimalarials for COVID-19

Volume 395 Number 10231

11 April 2020

WORLD REPORT US and French authorities have authorised the use of chloroquine and hydroxychloroquine, but the EU regulator and WHO say the science doesn’t support the decision. Susan Jaffe reports.

With no “adequate, approved and available” alternative, the US Food and Drug Administration (FDA) is allowing the use of the antimalarial drugs hydroxychloroquine and chloroquine to treat coronavirus disease 2019 (COVID-19).

The FDA’s emergency use authorisation (EUA) issued last week gives physicians the option to prescribe the drugs, which President Donald Trump has recommended. However, both drugs are unproven and untested for COVID-19, and have rare but potentially deadly side-effects. The decision bypassed the usual drug approval process including doubleblind, placebo-controlled clinical trials, stoking a worldwide debate about whether the drugs are appropriate for treating the disease.

“I think it was resorted to more out of a sense of desperation”, said Joseph Masci, an infectious disease specialist and director of global health at Elmhurst Hospital in Queens, a borough of New York City, which is at the centre of the epidemic in the USA. “It is just an indication of how sudden and massive this outbreak has been.” [Continued here.]

Appeals, CMS, DOJ, Medicare, Observation care

Federal Judge Rules Medicare Patients Can Challenge ‘Observation Care’ Status

By Susan Jaffe | Kaiser Health News | March 30, 2020| This story also appeared in

Hundreds of thousands of Medicare beneficiaries who have been denied coverage for nursing home stays because their time in the hospital was changed from “inpatient” to “observation care” can now appeal to Medicare for reimbursement, a federal judge in Hartford, Connecticut, ruled last week.

If the government does not challenge the decision and patients win their appeals, Medicare could pay them millions of dollars for staggeringly high nursing home bills….

“If I had gone home, I would have died,” said Ervin Kanefsky, 94, a plaintiff [in a class action lawsuit against Medicare] from suburban Philadelphia. He was admitted to the hospital as an inpatient after fracturing his shoulder in a fall. When he was about to leave after five days to recuperate at a nursing home, a hospital official told him his status had changed to observation. With one arm in a sling, stitches in the other and unable to hold onto his walker, he learned Medicare wouldn’t pay for the nursing home. [Continued at Kaiser Health News or The Philadelphia Inquirer.]

NIH

State Says Hospitals Must Allow Support Person at Births

FAMILIES | THE CITY | March 28, 2020

The state Department of Health has toughened up its message to hospitals that have been telling pregnant women they can’t bring a partner or other support person into the delivery room because of coronavirus concerns. The new visitation policy’s boldface wording, issued late Friday, appears to leave little open to interpretation.

It “requires hospitals to allow one support person in labor and delivery settings if the patient so desires and two designated support persons in pediatric settings, provided that only one is present at a time.”

…The update reverses visitor bans announced earlier this week by New York-Presbyterian and Mount Sinai Health System in response to the coronavirus crisis. Other hospital systems had been expected to adopt similar procedures. [continued here]

Global Health, The Lancet

Leadership changes at USAID

Volume 395 Number 102295 28 March 2020

WORLD REPORT Mark Green, the respected head of the US Agency for International Development, has resigned. Susan Jaffe reports from Washington.

“The timing is unfortunate”, said Jen Kates, senior vice president and director for global health and HIV policy at the Kaiser Family Foundation. “The agency is going to be significantlychallenged by the COVID-19 pandemic, potentially at a level that it has not seen before.” [continued here]

CDC, CMS, Long term care, Medicare

Coronavirus Stresses Nursing Home Infection-Control Practices

I-TEAM IN-DEPTH | CONNECTICUT HEALTH INVESTIGATIVE TEAM | MARCH 12,2020

As coronavirus cases increase, posing heightened risks to the elderly, nursing homes will face growing scrutiny from state health inspectors.

In Connecticut and nationally, complying with federal infection-control requirements is a challenge for some nursing homes. Between 2017 and 2019, 145 of Connecticut’s 217 nursing homes – or about 67 percent – were cited for infection-control violations, according to a Conn. Health I-Team analysis of data from the Centers for Medicare & Medicaid Services (CMS). [Continued here, with list of nursing home infection violations.]

Affordable Care Act, Drugs, HHS, Long term care, Medicare, The Lancet

Medicare for All scrutinised in Democratic primaries

Volume 395 Number 10225 29 February 2020

WORLD REPORT On March 3, 14 states will pick their nominees for the US presidential election. The feasability of a single payer insurance plan is a key issue. Susan Jaffe reports from Washington, DC.

Anxiety about rising health-care costs— the top issue for Democratic voters, according to recent polls—propelled Bernie Sanders to the head of the pack in last week’s Democratic primary contest in Nevada. Of the six leading candidates vying for the party’s presidential nomination, Sanders, a Vermont senator and self-described democratic socialist, has proposed the most radical solution for lowering medical bills and reaching universal coverage. His signature policy initiative, the Medicare for All single-payer programme, would eliminate private health insurance, including employment-based plans that cover about half of the US population. [Article compares Medicare for All and the public option proposal favoured by former Vice President Joe Biden; continued here]

CDC, NIH, The Lancet

Decisions to be made on US gun violence research funds

Volume 395 Number 10222 8 February 2020

WORLD REPORT The National Institutes of Health and the Centers for Disease Control and Prevention will decide how to spend new federal funds later this year. Susan Jaffe reports from Washington, DC.

After a hiatus of more than two decades, Congress and President Donald Trump agreed to add funding for gun violence research to the federal budget in December. With grants expected to be awarded in September, the priorities for research and its potential impact are crucial for halting the US’s record-breaking gun-related death toll. [Continued here.]