Our View: Toomey, Casey on right track to tackle substandard care in nursing homes

Whenever Pennsylvania Senators Pat Toomey, R, and Bob Casey, D, agree on something and decide to work together, it catches our attention.

We're absolutely riveted when that something would provide additional inspections and oversight at underperforming nursing homes.

Heck, in May, we advocated for more inspections at Pennsylvania's long-term care facilities ourselves, particularly since we believed then — and we still do today — that these sites — even more so than our hospitals — are where the battle with COVID-19 will be won or lost.

More than 30,000 nursing home residents and some 6,200 workers have been infected across 11,200 facilities statewide, according to the Pennsylvania Department of Health.

Toomey says that two out of every three of the commonwealth's COVID deaths have been nursing home or long-term care residents. That's about 6,200 of approximately 9,500 coronavirus-related deaths.

Toomey and Casey's interest in what's happening inside nursing home facilities predates COVID. In June 2019, the pair released a report "uncovering poor care in America's nursing homes." COVID wasn't on the radar then, but the report mentions filthy conditions, lack of proper nutrition, physical and sexual abuse, insect infestations, supply shortages and other indicators of poor care.

It also highlights the federal Special Focus Facility program's shortcomings. The SFF program was created by the Nursing Home Reform Act of 1987, which overhauled federal nursing home oversight in the wake of a damning Institute of Medicine report exposing substandard care in American nursing homes.

The SFF program is the vehicle by which the Centers for Medicare and Medicaid Services can designate a nursing home for increased oversight if it "substantially fails" to meet Medicare and Medicaid program care standards and resident protections in its three most recent surveys. Participants in the program must be surveyed every six months rather than every 15 months.

Here's the problem, as Toomey and Casey see it. Due to a lack of funding, the program can only enroll 88 nursing homes in the entire country. Yet the program typically identifies another 400 or so candidates that qualify due to "a persistent record of poor care" but get no additional oversight because the funds aren't available.

Just as concerning for residents who are shopping for an elderly family member's nursing home, the Centers for Medicare and Medicaid Services discloses the names of the 88 selected participants, but not the 400 that would be on the list if funding allowed.

For the record, four Pennsylvania nursing homes were on the 2019 SFF program list — The Gardens at West Shore in Cumberland County, Twin Lakes Rehabilitation and Healthcare Center and The Grove at North Huntingdon in Westmoreland County, and Falling Spring Nursing and Rehabilitation Center in Franklin County.

In a move we love, Toomey and Casey took it upon themselves to publish the names of the other 400 or so facilities because they believed the transparency was crucial for people who are trying to decide where to place a cherished family member.

The 2019 list of candidates getting no additional oversight includes Brighton Rehabilitation and Wellness Center in Beaver County, The Gardens at Stroud in Monroe County, and the Chestnut Hill Lodge Health and Rehab Center and Garden Spring Nursing and Rehabilitation Center, both in Montgomery County.

All of that happened before COVID raced through Pennsylvania's nursing homes, reinforcing what Toomey and Casey last week called "the urgent need to improve care quality in the subset of nursing homes that persistently fall short."

Their statement came as the senators are trying to generate support for their Nursing Home Reform Modernization Act of 2020, which they introduced in late October. In short, it would expand the SFF program to include heightened scrutiny not just for the 88, but for the other 400 as well.

If Toomey and Casey are looking for more support for their bipartisan proposal, they certainly can count on ours. Both oversight and transparency are sorely needed.