GSA Member's Senate Testimony Highlights Nursing Home Needs During Pandemic and Beyond

Speaking today at a hearing of the U.S. Senate Special Committee on Aging, University of Chicago professor R. Tamara Konetzka, PhD, told lawmakers about the relationship between nursing home quality and COVID-19, and shared measures to reduce the effects of the pandemic on nursing homes.

Senators convened the hearing, titled "Caring for Seniors Amid the COVID-19 Crisis," to investigate the disproportionate harm older adults across the country are experiencing due to COVID-19 and explore what can be done to better protect this population.

Adults age 65 years and older are more likely to suffer severe complications from COVID-19 and to have more difficult recoveries. They represent two out of every five hospitalizations and eight out of every 10 deaths from the virus. Those in nursing homes and group care settings are especially at risk. Nationwide, residents and workers in nursing homes and other long-term care settings represent more than one-third of all COVID-19 deaths.

Konetzka is a professor of health economics and health services research at the University of Chicago, and a long-standing member of The Gerontological Society of America (GSA). She and collaborator Rebecca Gorges, MA, recently set out to assess whether the pattern of COVID-19 cases and deaths in nursing homes appears to be random or connected to nursing home quality.

"We conclude from this analysis that at least the standard quality measures do not distinguish which nursing homes ended up with cases and deaths," Konetzka said in her testimony. "While some nursing homes undoubtedly had better infection control practices than others, the enormity of this pandemic, coupled with the inherent vulnerability of the nursing home setting, left even the highest-quality nursing homes largely unprepared."

She added that, consistent with racial and socioeconomic disparities in long-term care historically and in pandemic-related deaths currently, nursing homes with traditionally underserved populations are bearing the worst outcomes.

Konetzka also said that given the high rates of COVID-19 infection and death among long-term care facility residents and staff, reducing risk in long-term care facilities must be a top priority.

"I would place the most promising interventions into three categories: resources aimed directly at long-term care facilities; resources to enable prospective or current residents funded by Medicaid to receive services at home rather than in institutional settings; and requirements for data collection and transparency."

Regarding more long-term measures to improve nursing home quality and reduce future risk, Konetzka said that the structure and level of nursing home funding, or long-term care funding more generally, has to change.

"At least, Medicaid rates need to be substantially higher to address our chronic under-funding of this critical health care sector" she said. "At best, the fragmented system of state-specific payment rates and cross-subsidization from Medicare would be eliminated altogether, consolidating long-term care payment into one consistent program."

The Gerontological Society of America (GSA) is the nation's oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society — and its 5,500+ members — is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA's structure also includes a policy institute, the National Academy on an Aging Society, and an educational section, the Academy for Gerontology in Higher Education.