This is just over two hours. Let me begin by thanking our panelists and members of at todays briefing. 40,000, the latest estimate of how Many Americans in Nursing Homes and other longterm care facilities have lost their lives as a result of the coronavirus pandemic. The men and women who died at these Nursing Homes were parents and grandparents, who sacrificed to provide for their families. Some were veterans who fought to protect our country. Many were essential workers who kept showing up to care for the elderly and the sick, even when it meant risking their own lives as our nation faced more deaths from coronavirus than any other country. Lets be clear. These 40,000 americans deserve better. Their deaths in our nation to protect our people. There were warnings. In february the coronavirus attacked the Life Care Center in kirkland, washington. Three quarters of the residents at that facility became infected, along with dozens of staff. 37 people died. Four months later nursing home residents or workers had been infected in every single state in the country. Nursing home residents have died from the virus in every state in the United States of america. Many of these deaths could have been prevented and we must ensure more lives are not lost unnecessarily. We know that personal protective equipment like masks, gloves, can help stop the spread of the virus, but without a comprehensive National Plan to acquire and distribute ppes, many Nursing Homes ran out. Others were forced to reuse masks, create their own, or go without. Even today these shortages continue. Federal data shows that more than 500 Nursing Homes lack n95 masks. More than 250 Nursing Homes have run out of surgical masks, and another 800 are close to running out. Hundreds of other Nursing Homes face critical shortages of gowns, hand sanitizers and other supplies. We know that rapid and frequent testing can save lives. Last month, the seniors for medicare and Medicaid Services recommend that nursing home tests all residents and staff. Without the comprehensive National Testing plan and distribution of testing supplies, Nursing Homes see in at least half of the states are unable to conduct the recommended testing. We all know that healthy, safe Nursing Homes need to be fully staffed with workers who are treated well and paid fairly. Yet, many facilities have cut staffing to boss profits, while paying workers a little more than minimum wage and provided no Health Insurance or paid leave. Think about that for a moment. If a nursing home worker feels sick, he may have no choice, but to work report to work anyway or risk losing their only means of supporting themselves and their families. We must do better. I hope that todays briefing will help lead us through simple clear steps that the federal government can take now to protect vulnerable americans in Nursing Homes who are relying on us to get this right. That includes stronger oversight and more federal leadership on testing and protective equipment. Today well hear from briefers that are at our nations Nursing Homes. I am particularly grateful to Alison Lolley whose mother tragically died after contracting the coronavirus in a nursing home in monroe, louisiana. Miss lolley, thank you for agreeing to join us today to share your story. I also want to recognize that members of our committee have been personally affected by the Coronavirus Crisis in our Long Term Care facilities. Share woman waters. I want to thank you for joining us in this important briefing and again, extend my deepest condolences for the loss of your sister. Now, i am aware that some have tried to make deaths in our nations nursing home a partisan issue. I hope we wont call into that trap today. Nursing home residents have died from the coronavirus in states governed by republicans and democrats. In big cities and small towns, in rural and urban communities. What unites them is that theyre all americans and our nations government must take responsibility for keeping them safe. With that, i will turn to the distinguished Ranking Member for his remarks. Thank you, mr. Chairman, i thank you for calling this important hearing. As we face the serious challenges for us, i first want to start today with positive news. After a long and difficult few months, the american recovery is finally underway. All 50 states have finally begun reopening. Last week, we just got the may jobs report and instead of what was expected to be a 7 1 2 million additional job loss, instead we shattered the post world war ii by creating 2. 5 million new jobs in may. Thats a swing of 10 million jobs to the positive. The Paycheck Protection Program that we passed together, republicans and democrats working with president trump, has made loans more than 4. 5 million small businesses. Thats to save millions of american jobs for those hardworking families that have joined them today. Clearly the work weve done have helped americans make it through some of the toughest times in our nations history and now were seeing the American People burst out of their homes with energy and determination to get back to work and to make america a more perfect union. Todays weekly unemployment claims remind us that we still have work to do. Our job now is to keep this recovery moving forward. While we know the virus is still out there, we also know that theyve turned a corner in our response. Weve conducted more than 3. 2 million tests just in the past seven days. Production and delivery of ppe increases daily. The private sector, fema and hhs have delivered tens of millions of n95 respirators, surgical masks, face shields and gloves delivered. Under president trumps leadership, fda expedited promising therapies and vaccines tested as we speak. Make no mistake, covid19 is an insidious and evil enemy as todays hearing underscores. This attacks the elderly at an alarming rate. Our job is to protect those most vulnerable. Nursing home residents make up only. 6 of the american population, yet they have accounted for over 40 of the National Covid19 deaths. This is unacceptable, mr. Chairman, and more sadly, this was largely avoidable. The decision of several governors to essentially mandate that covid positive patients go back to their Nursing Homes, even if those Nursing Homes were incapable of properly treating them, ended up being a death sentence. For new jersey, its more than that, 6,309 deaths, compare that to florida which is a retirement state which had less than 1500 deaths. All tragedy, but wide disparity. On a per capita basis Nursing Homes deaths in new york are 500 higher than in florida. In new jersey its worse. Over 1120 higher than in florida because of those decisions. Other states like michigan, california, and pennsylvania, that put covid positive patients back into Nursing Homes. We should focus on what went wrong to stop that from happening again. What happened. On february 6th, the first guidance for positive coronavirus patients. C. D. C. Saw this unfolding in europe, on february 29th america experienced the first nursing home outbreak in washington state. They updated the guidance to treat them. And said quote, under no circumstances should a hospital discharge a patient to a nursing home that is not prepared to take care of those patients needs. That was a clear directive, unfortunately, on march 24th, Governor Cuomos Health Department issued this directive in contradiction in regard to the guidance mandating that Nursing Homes take covid19 patients. New jersey essentially copied verbatim the same directive from new york with similar deadly results. Two weeks early, Governor Desantis prohibited transferring patients who were positive to Nursing Homes. Different orders yielding very given results. In march, pennsylvania issued guidance mandating that nursing home patients continue to accept new admissions, readmissions, including patients that were covid19 positive. While defending this decision, even Pennsylvanias Health secretary moved her mother out of a nursing home. On april 15th, the governor of michigan issued a similar executive order, mandating, mandating that nursing home patients have to be accepted regardless of covid19 status. Even if they couldnt properly take care of them. Again, in contradiction to the cms directive. Michigans state representative, who is a democrat, ashley love, criticized that publicly calling this reckless order an epic fail. Mr. Chairman, shockingly this order in michigan still remains in effect today. Im calling on Governor Whitmer to rescind this order immediately. And i hope all of my colleagues join me in calling on this to be rescinded because it is having deadly devastating consequences for seniors who are covid positive in Nursing Homes. Ive drafted letters for each of these governors requesting information on what led to these tragic decisions. I would ask all members of this subcommittee to sign onto this letter so we can get that information and prevent more unnecessary deaths from occurring. Lets work on a bipartisan basis to get all of this information out there, to ensure that these deadly mistakes are not repeated. Again, mr. Chairman, look, the American People are deciding to get back out there, to reopen the economy, to get back to work so they can rebuild and get their jobs back. It its too many for us to stand together for justice and equality. To do that demands that we protect those most vulnerable from this virus. We need to correct the mistakes made so no more needless deaths occur. I yield back. Once again welcome our panelists and introducing the experts and Community Leaders with us today. Thank you again to each of our briefers for joining us. Well hear from Alison Lolley who i introduced earlier and also from chris brown who worked in chicago where it was ravaged by the pandemic. Mr. Brown has seen firsthand the shortages of personal Protection Equipment and testing and contributed to an outbreak. And he has experienced the stress of working in the days of his job. Also with us today is eric, director attorney of justice in aging. A Nonprofit Organization that advocates for Affordable Health care and Economic Security for our nations seniors. Mr. Carlson will discuss how the federal government can better protect americans living in longterm health care facilities. Next, you will hear from phil kishland who served as president of finally, hear from president david from Howard Medical School who has studied Nursing Homes for many years. Professor grobowski will talk about why Nursing Homes have been devastated by the coronavirus and what steps we can take today to prevent further outbreaks. I would like to recognize now miss lolley for an Opening Statement. Miss lolley. Good morning, chairman cliburn, Ranking Member scalise. My mother died in april in a nursing home in monroe, louisiana. Im grateful for the invitation to share my familys story today and it is my sincere hope to have robust oversight in response to the covid19 crisis. My mother was admitted on december 31st, the oaks allowed us an opportunity to visit her frequently. The only concern we had was heavy staff turnover as she was admitted. First the administrator, then the director of nursing, and a social worker, just created anxiety for our family. So much so that i reached out to the oaks owner for help in navigating an untenable process. It was a harbinger for problems to come. On marv march the 5th, i received a letter from the oaks by u. S. Mail and one who was filling in while they were recruiting. The letter ent pred coronavirus concerns among the family members and helping to row dues the virus from entering the building. At some point before march 11th, another letter an i arrived. And this requested that family and friends do not visit the facility. Went on to say that the facility was following recommendations from the c. D. C. And they were in close contact with local and state Health Departments and they were following their guidance. My family made the conscience decision and commitment to follow the requests of the oaks. We began to see vacillating practicing by the staff and mom had begun to look disheveled. She would gently complain things didnt seem right and on more than one occasion, she shared that she was not fed a meal all day. I found a third letter dated april 18th, informing us that one tested positive of covid19. When we could call and with whom we could speak. I made my first call at 10 a. M. And i went to the voice mail and that process went on until 2 p. M. When i never heard back i texted the director and told that the rn had been slammed with calls and doing their best to return them as quickly as possible. I began asking questions. What was the job of the covid19 infected employee and what interaction did he or she have with my mother. Were there any other cases in the oaks and what was the procedure of removing my mom from the oaks if we want today make that joist. Unsolicited i was told by the director while she could not guarantee anything, she felt confident that they were past it. There had been a period without any additional infections and that she personally had evaluated the entire situation. We decided to keep mama in the oaks as long as there were no more cases. The director of region responded to my Text Messages twice daily with an update on cases. Until the evening of april 20th, i texted twice a day and each time received the answer there were no new cases. On april 21st, i sent my text, no reply. I texted again and asked if everything was okay. I got a text that said, im okay. Unbelievably busy, residents are good. I asked again about new cases. Her reply was, the best way to help me work effectively is by limiting calls and texts. I assure you that you will be notified of my changes. Our residents and staff deserve my full attention and i will continue to answer the call when your mom needs assistance with her care. Throughout this harrowing experience i talked with every resource at the oaks regarding their lack of communication. The residents families needed consistent factual information to help make decisions. I was met with little to no interest and no commitment to transparency. Our family continued to watch mama deteriorate. She complained of lack of care, attention, and man handling from people in her room whom she did not recognize. During with unvisit to her window, i found mama, unclothed, unkempt and confused. On april 23rd at approximately 2 p. M. I received a call from the oaks, terrified of what i was about to hear, a nurse told me that my mother was being transferred to the hospital. The nurse stated that she had returned to work at the oaks and when she saw my mother, she didnt look right. She also shared that mamas o2 rate was dropping and she was confused. Mama was transferred to st. Francis Medical Center and admit today the covid unit. Mama died in the unit on april 29th at 5 05 and she was alone. In closing, let me acknowledge that i have kept myself abreast of the data and statistics and i understand all the factors that led to the impact of the coronavirus on Nursing Homes, regardless, there was plenty of time to prepare. The first nursing home cluster was documented in seattle in early march, but i could not get any hard facts on nursing home cases in our parish. Nor could i get any level of comfort regarding a plan. The fact is my family was robbed. Mama was trapped in a petrie dish and we were shut out. Mama died alone and our family will forever be scarred by this tragedy. I implore each of you to continue your due diligence. Evaluate best practices like we see coming out of florida. Find the caregiver within the nursing home who can tell you what really happened inside when they witnessed firsthand the care for our most vulnerable and treasured loved ones. The oaks is a forprofit business that was not prepared to handle the crisis due to expected turnover, staff, lack of disaster protocols. They lacked a communication plan that allowed families to make informed decisions. Please, reform this industry. Properly fund this industry and do it quickly. Let not let my mother die in vain. Thank you. Thank you very much, ms. Lolley. I want to now recognize mr. Brown for an Opening Statement. Mr. Brown. Thank you. Good morning to the members of this committee, thank you for allowing me to share my story today. My name is chris brown. I am a nursing home worker from chicago, illinois, and also a proud member. Sciu, illinois, michigan, indiana. Ive worked in the Health Care Industry almost 10 years. First patient i took care of was my grandfather. When someone had to work, i made sure he had his medicine and happy to help him and keep him in his best possible spirits. This was inspired to keep me and make me want to work on Nursing Homes. Although the work is very rewarding, i alone with my other Nursing Homes workers face many challenges and the truth is, these challenges and these things was going on before covid ever existed. One of those challenges are short staffing. I worked on a floor where the residents are bedbound. They cannot speak, they cannot move. It takes lots of physical to move them. We make sure they dont have bed sores, change their soiled garments. Short staffing means less help w covid19 short staffing means coming into contact with more residents even when there was a specific floor for residents who were infected with covid19. Short staffing means nursing home workers were spread thin. When workers come into contact with more residents, the risk of exposure to covid19 is heightened. We dont know if the residents are a tested when they arrive, if the residents are only tested when they have symptoms, by then, its too late. If i become sick how can i take care of somebody else . Who will take care of me. If i end up working sick, the virus could spread like wildfire. If i dont come in, i cant pay my bills. If i have to choose between keeping the lights on or my health. Being low grade ppe compounds the risks. I have more contact with residents than medical staffs at Nursing Homes where i work. I only have one mask, some were placing them in paper bags. And i had to wait four weeks between the first case of covid19 appearing and the time i knew, i never knew whether i came in contact with the patients, if i was i was scared that entire time and eventually had to move out of my house because i was afraid of getting my family sick. I havent seen them since. Its difficult not to be able to see your family. I have 13 brothers and sisters, we all worked to take care of my grandmother who has dementia. Every day my grandmother is moving a bit of herself. In the last precious moments im going to miss because of covid19. The time ive been spending with my grandmother, im sorry the time i havent been spending with my grandmother im developing relationships with people in the facilities, unlike my grandmother, many of these residents dont have family members. Sometimes we end up becoming the only family they know, so i spend time telling a good joke, putting a smile on residents faces and keeping them company. Thats why we need to invest in Nursing Homes, nurses and residents and address short staffing in both heavy emotional and physical labor. If theyre paid what theyre worth. If we can they can live in dignity and comfort. There have been efforts in my facility to bring in new people, but unfortunately, these workers are too undertrained to provide the health that we desperately need. At most, they can pass out trays and they dont qualify to be in direct contact with residents. We need better training standards. Together with my union family, we have been able to make some progress. Nursing home workers across the lobby to springfield, illinois and share our stories of being understaffed and working without benefits. Just recently, we were able to win pay increases for Nursing Homes in chicago after 5,000 people can go on strike. Including the 2 increase for hazard pay. An addition al paid sick days, but its still not enough. All of these issues i mentioned are still there. Theyre not unique to my facilities. Nursing homes across the country say theyre not adequately protected from covid19. Theyre calling for paid sick days, double time has ard hazard pay, and free testing for covid19. With the pandemic disproportionately affecting communities of color and acknowledging the majority of workers are black and of color, Nursing Homes continue to get hit hard. I hope and pray for this change to be better. Our families depend on it and i want to thank you guys for letting me speak. Thank you very much, mr. Brown. Id like to recognize mr. Carlson for an Opening Statement. Thank you. My thanks to the chair, the Ranking Member and also other Committee Members for the opportunity to be with you today. As has been noted the pandemic without a doubt has taken a terrible toll on nursing facilities and nursing facility residents 35,000 deaths, approximate approximately a shocking number as mr. Brown noted disproportionate impact on people of color. A couple of interrelated questions that are important to address today, why has there been as mentioned in the title of todays briefing, such a devastating impact on nursing facility residents and secondly, of course, what can the federal government do to address this problem now and in the future. First, i would suggest that we look at the longstanding quality of care problems in many nursing facilities. I work with nursing facility residents on an issues for 30 years. Some provide good quality care, but theyre often the exception. Facilities are frequently shortstaffed as mr. Brown and ms. Lolley noted and puts nurse aides like mr. Brown, you dont have residents time for adequate attention. The Government Accountability office recently released a report on infection practices, and whats going on now, 82 of the facilities were cited one at least for prevention deficiency in a fiveyear period. Almost have commit add violation multitime times a year. Every time they showed up. They were indicators of persistent problems. These are the kind of persistent problems that have manifested now, this year, in covid19 infections and deaths. While the problems have been exacerbated, mr. Brown noted, they noted difficulty obtaining personal protective equipment in covid19 tests and i expect the professor will have more to say on this topic, but i wanted to point out the lack of federal coordination has certainly impeded facilities ability to identify infected person and provide care and particularly, that the absences remains important as facilities are attempting to open up which requires, tense seive intensi intensive and id like to look at other areas where improvement are important. Here is to this point that its beneficial to house covid positive residents with other positive covid residents. With cohorting, the facilities have to transfer and to a greater extent the facility decided if its going to be a facility specifically for covid positive residents. This discretion relatively unfettered given to facilities puts residents at risk in a couple of ways. First, they may not receive any notice whatsoever before being transferred out. And that facility theyre doing to, may have nominated itself to care for covid positive residents even though it may have a low quality of care. If my chin statement, subperforming facilities, indeed, have put themselves or promoted themselves to care for covid positive residents. Suggested theres a role for the federal government to provide some type of advanced notice . Do they have some type of control where theyre to live and cms should set fom minimum standards for the filth that focus on covid residents. These are residents at incredible risk and we should make sure their care is of the highest standard. Another beneficial upgrade is prevention. Under the current regulations its a parttime position, no specification, parttime, 10 hours a week as a practice, this is a facility nurse who has taken on additional designation as infection preventionist. Given the risk of covid19 this has to be expanded significantly with the position of fulltime or close to fulltime with commensurate increase in responsibilities and in training. Note that california already is acquiring, as far as facilities mitigation plan, that infection preventions work on a fulltime basis and pending house legislation would require the same. So, i submitted a written statement and obviously, they will have the discussion to discuss all of those. Id like to close by pointing out that theyve nursing aide standards and mr. Brown referred to folks who dont have adequate training in their facility. Ordinarily if a nurse aide can provide handson car after only 16 hours of training, again, within the first few months, they have to complete 75 hours of training and pass a skills examination, but those requirements have been waived completely right now. Theres no training requirements whatsoever. Its important that cms reinstate these training requirements and at this point the risk of not having enough nurse aides is outweighed by the risk of direct care staff provided by persons who sim mr. Dont have the adequate training. Dont have the adequate training or experience and shouldnt be any grandfathering of people brought in with no trainingment now is the time to reinstate the standards to make sure the quality of care is high. Again, i very much appreciate the opportunity to speak with you all today. Its an incredibly important topic and i applaud your trt. Thank you, mr. Carlson. Id now like to recognize mr. Kirkland. Hi, thank you so much for inviting me and having this hearing, it is, i believe, the most important subject for congress and for our country and for the media to be looking at right now. And really, really, overall at anytime with respect to this pandemic because this is overwhelmingly the population thats at risk and is dying from this disease. Weve heard a lot of people used used weve been compiling the state source data every single day and the state source data already shows significantly higher numbers than that. We have the number now of National Covid deaths in longterm care facilities excluding the state of new york and ill explain why we do that, we have that at about 55 of the covid deaths nationally. A pretty clear majority. Its been rising. When you look at most of the states with the most complete data it could be 60, 70, sometimes as high as 80 in states like iowa and minnesota among the population of longterm care facilities. That shouldnt surprise us. If you look at age stratification table that i included in the written testimony. This is based on the new c. D. C. Data released yesterday and we now have in this country about 60 of all covid deaths above 75. And its an extremely, extremely age stratification kind of all the way through. Really, you dont have any significant number of deaths until you get to at least age 45 and theyre still less than deaths from other causes. You dont have more percentage of deaths from covid, until above age 65. We need to focus on the older population and we know where many of them are and the most vulnerable of them are and thats in the nursing facilities. Of course, we should have known this after the pandemic came to america, those were the people who died in china, and in europe. Almost every european country that has good data has more than half of their covid deaths of residents in longterm care facilities. Yet, weve pursued the most expensive possible policy response locking down the entire society and closing schools, despite children are at far less risk than seasonal flu. We frighten low risk adults and children, all in the name of saving seniors and into Nursing Homes, the worst policy response if youre truly trying to protect the vulnerable. One of the worst jobs reports weve ever seen in our lifetime was the april job report showed Nursing Homes shed 113,000 employees in that month, in that most crucial month for them to be able to deal with this. They were losing a massive number of employees, i think we need to learn why that happens, whether its just the economic crash collapsed everything and there were layoffs, including them. Whether School Closures forced them to stay home with their children and its a key problem to figure out why that happened. We have data on all of this included here, i wont run through it, but i want to talk about seven states in particular, there were seven high volume mortality states that together account for about 65 of all of the covid19 deaths in the country. The five northeastern states, new york, new jersey, connecticut, pennsylvania, massachusetts and the two midwestern states, illinois and michigan. Youll note these are not the largest and most populous states, but overwhelmingly have most of the covid19 deaths and what they have in common to get to the point that the Ranking Member was making in his Opening Statement, they all adopted some version of the policy of requiring Nursing Homes to take patients whether they had the ability to isolate them or not. And i believe that was the key policy error that led to large volumes of deaths in those states. New york is very interesting because new york does not report the number of longterm care residents who died unlike other states, only that those who died in longterm care facilities. The majority of residents who die are hospitalized prior to death so the 6,300 number that we have in new york is probably half or even a third of their total longterm care deaths. Thats why when you look at it, you have to exclude new york. If new york would give an honest number, they used to report the same as the other states, at the end of the april they added that footnote and stopped giving us the number. I think its important for congress to understand the scope of this from new york and they need to be pressed on that. And they ran through the numbers so i wont do that. Ill quote from a medical doctor, a caretaker in pennsylvania who tried to get hospitals to take his patients. The two weeks in philadelphia, hospitals are empty waiting for a new york style surge, but the Nursing Homes, effectively clustering covid in one unit. They refused. We asked to utilize a large room to cohort patients. They said it wont possible. I spoke to a nice hospitalist who was receptive to the idea of boarding Covid Patients from the nursing home in the half empty hospital before the entire nursing home would get infected. Absolutely not was the answer. I was told the more fruitful endeavor was to go over advanced directive. If they get too sick hopefully they dont need to be resuscitated, its bad. And pennsylvania now reports about 69 of their total covid19 deaths among nursing home residents, about 4,200 deaths as of their most recent report and really its those seven states that adopted versions of this policy where they have 50, 60, 70 of their overall deaths where it was the driver of spread, the nexis of spread driving the nonNursing Homes deaths as well and accounts for the majority of the deaths in the country, the super majority in fact. I will leave it at that. Ive run out of time, but covered it in written testimony, a lot of states did much better with the same resources and deployed them much more effectively and had much better results and i hope that if we increasing spread or a second wafer, we will target the help and resources and intervention for people at risk and not much less effective the thank you. Chairman clyburn and the committee, thank you for addressing Nursing Homes. Let me be blunt, covid has devastated Nursing Homes. Reporting cases among their residents and their staff. Over 40,000 americans have died in Nursing Homes and many of us think the true number is higher. 0. 4 of the entire u. S. Population represents nearly half of our countrys covid fatalities. Efforts to stem this plague are taking a huge toll. Nursings home are in allout lockdown because visitors are banned, family members have been unable to see their loved ones going on three months now. Staff are frightened, given the lack of testing and personal protective equipment or ppe. The facilities are experiencing severe Staff Shortages as many individuals arent able or unwilling to work in these conditions. We hear a lot about the heroes working in hospitals, but individuals working in Nursing Homes, like mr. Brown, who are making close to minimum wage and risking their health, they are heroes, too. Nursing homes have been underfunded for years and to quote a colleague, a crisis on top after crisis. What do we do about all this . First we need to determine whether covid has entered certainly Nursing Homes and not others. Some are suggesting that covid is a bad apple and ineffective state policy or poor nursing home practices. However, our research and the research of colleagues at Brown University and the university of chicago suggest covid cases are not concentrated in low Quality Homes or in states with particular policies. Rather, cases are concentrated wherever covid is present in the community. The secret weapon behind coiffed is that it spreads in the absence of any symptoms. Visitors have not been allowed in most facilities since march, but staff, unknowingly bring the virus from the community into the facility. Plus, if covid is in the community where staff live, covid is soon to be in the nursing home where they work. It suggests, covid is not a bad apple problem, but a system wide problem that can impact any nursing home in any state. This is a time to support all our Nursing Homes. What shall we do . Staff and residents are in desperate need of covid testing. Until we get rapid and accurate testing for all staff and residents we wont be able to contain covid. This cant be a one on off. We need one that regularly tests staff and residents to identify new cases as they emerge. The virus also spreads because staff lacks ppe. Theres a huge shortage of masks, gloves, and gowns, thats led to staff reusing these supplies or simply going without. Rather than pushing the logistics and costs of testing and ppe to states and Nursing Homes, the federal government needs to own this issue. The federal government should set a consistent policy across all u. S. Nursing homes and provide states and Nursing Homes with the sources to achieve it. If we have the ppe in place we would be able to open Nursing Homes to family members like miss lolley who could have visited her mother. And the other is the care work force. Staff also deserve a wage that is commensurate with the risks they are taking. The federal government needs to put dollars in place that flow directly to workers in terms of hazard pay and other benefits. I want to conclude with a very simple statement. It didnt have to be this way. What do i mean by that . Much of the negative impact of covid in Nursing Homes could have been avoided, however, rather thannize than prioritizing the safety of those living in Nursing Homes ap staff that cares for them, we did not invest in ppe. And allowed it growing to a national crisis. Now that were here its time for the federal government to make the necessary investment, mitigate the spread of covid across all Nursing Homes. We owe it to our parents, grandparents and individuals who care for them. Thank you. Thank you very much, dr. Grabrowski. We will now have five minutes allotted to each member to ask questions and let me begin the questions by asking miss lolley, you gave some very emotional testimony about your mother and i would like to know from you, what is the one thing that you would have liked to have gotten from the nursing ho home . What is the one recommendation you would like to offer as to what would make your experience with your mother a better one . Thank you. Communication. Communication in realtime would have, i think, helped me ask more strategic questions of local officials and state officials so i could have pushed harder for testing. Well, thank you very much. I would like to ask mr. Carls mr. Carlson, youve testified about the rates of disparity in Nursing Homes. What steps would you suggest that the federal government would take regarding that issue . Well, what initial step would be to be able to identify the problem better, at that cms and the c. D. C. Right now have demanded as part of transparency that facilities record infections and deaths in facilities, but this doesnt include any demographic information whatsoever. And that should be that should be expanded so that we have a better sense of the populations that are coming ill and passing away in nursing facilities. Secondly, i think a lot of the broader policy proposals that we talk about are designed to improve care, particularly in facilities that have a disproportionate number of residents who are persons of color. This includes the increased staffing that mr. Brown and support for staff and mr. Brown and professor grabrowski referred to, and also, i stand with ms. Lolley by pointing out that there should be a more nuanced way to allow residents to remain connected with families, that particularly as this emergency has continued the inability of residents to be able to communicate with family members, has become incredibly difficult on a variety of models. Thank you very much. I think i have time for one more question. So id like to ask mr. Brown if he could offer just some suggestion as to how from his experience, things could be done a little bit better to protect himself and the residents . Mr. Brown . Thanks, i really appreciate that question. That theres a lot that can be done that i probably dont have time to go over. One thing effectively my problem is communication, us being and working in these facilities, knowing that we have a covid patient coming into the facility. Knowing where theyre going to be and what the standards are that surround how to deal with them. The appropriate ppe, as far as ppe, there were times being in there i had worked and had to put a garbage bog on to a garbage bag on because the people needed to be taken carry of. And staffing, language around staffing, and how many residents and or patients they can see per half shift. This is not abided by at all. Were not getting enough towels and soap, things of that nature. For me having the about. Pe, be covid best practice, standards in place would have helped me a whole lot. Well, thank you very much, mr. Brown. The chair now recognizes the Ranking Member for five minutes. Mr. Scalise. Thank you, mr. Chairman. And appreciate again the witnesses, your testimony. Miss lolley in particular, i just want to express my condolences for the loss of your mother cheryl at the nursing home in monroe. I represent, in my district, i have the lament house in new orleans and early off that was one of the Nursing Homes with the highest number of deaths per capita, probably around 25 deaths there and they stopped counting the way that we could find a true number, but devastating as well we were able to get some guidance from c. D. C. But not being able to visit your mother, i cant imagine how it you have that would be. My condolences to you. Lets use this to find out how we can do better. And that goes to some things i talked about earlier and surely want to dig into this deeper. We still are having people dying in Nursing Homes that shouldnt be. And people who are shutting at home and are getting it and weve stemmed the curve and starting to see a climb. The hospitals are not overrun like some of them were and now were starting to reopen. We need to keep learning about this disease and especially how its at a disparate income and people in Nursing Homes. I still look at the numbers and this is about data and what we can to do do better. There are directives given out by governors that had a much different outcome than in states where they didnt do this. And when cms put the guidelines out, cms told states how to take care of seniors in Nursing Homes. If you cant take care of your senior in an isolated way, if theyre positive for covid, then you shouldnt bring them back. And most governors did that. Democrats and republicans. But there were some. And mr. Chairman, this is the thing that we need to be looking at because we want to find out what happened, but we want to stop this from happening again. In new york, the governor literally gave a directive, its dated here, march 25th. No resident shall be denied readmission or admission to the nursing home solely based on a confirmed or diagnosis of covid19. Went on to say, Nursing Homes are prohibited from requiring a hospitalized resident determined medically stable to be tested for covid19 prior to admission or readmission. Im with you there, the governor prohibited the nursing home from testing. Thats lead to deaths. After 40 days the governor of new york rescinded, but thousands of people died during this period. If that wasnt still going on we should find out about it. New york needs to be transparent with the numbers. I dont know why they stopped reporting the numbers. Theyre out there and recorded. But if you look at michigan, the governor of michigan do the same thing and its still going on and i call on all members of this committee to join me on calling on the governor of michigan to rescind this order. People are dying unnecessarily in michigan in Nursing Homes and we know now what the results are if you do this and theyre still doing it. My goodness, i mean, that has to end. And so, i want to ask, why do you think some of these orders were given in contradiction to cms guidelines and why are some of these in effect in a state like michigan, and should that end . Well, look, i think these orders were given for basically two reasons. One is the states were worried about reserving Hospital Capacity and thought they could be overrun and keeping is it clear and then take them you figure it out. And new jersey did at one point adopt and amended the order and said you have to isolate them properly and cowho are the them. But a whistleblower from new jersey said it knew the nursing home couldnt meet that requirement because they didnt give them adequate ppe because they would rather give it to the hospitals more visible and more important from the media standpoint and same thing with testing, with public testing because they thought it was more for Public Relations and media standpoint than to put it where it did the most good. There was a reallocation error like the pennsylvania story i read in most places trying to keep hospitals empty for a surge from the community that never showed up. So the hospital stayed empty while they were not serving Nursing Homes. And knowing what we know now cms has given over 14 different guidances show how to properly do this and michigan is still doing it and people are dying. Knowing what we now know is there any reason that it should be going on in michigan . Its pretty crazy for the socalled hub facilities which many people believe cannot properly isolate these patients and protect nonCovid Patients. Talking about the decline in hospitalizations. Thats not true. In taxes, north and south carolina, california, oregon, arkansas, mississippi, utah and arizona increasing numbers of covid19 patients are showing up in hospitals. For example, texas has reported to my consecutive days of recordbreaking coronavirus hospitalizations. This date which is one of the first to reopen has seen a 36 increase in new cases since the end of may with a record 2056 hospitalizations recorded by tuesday afternoon, the post reported. Let me talk about Nursing Homes. In an article, employees of a nursing home were joined, joined the state Healthcare Workers Union on monday in demanding paid sick leave and other protections after learning that a coworker died of covid19. Cynthia whitfield comes to eight, died april 21 of the the disease, a week after she was hospitalized at st. Marys, said her daughter. A certified medical technician at grand manor nursing and rehabilitation, cynthia was waiting covid19 test results when she told her employer aprih and severely fatigued, her daughter said. I have full of other employees have tested positive for the disease at the outbreak that sickened dozens of residents. And so what are we talking about here . Grand manor at 3645 cook avenue in north st. Louis is one of several Nursing Homes across the st. Louis area that have denied workers paid sick leave, hazard pay and other protection, said a director and Vice President of the union which represents 4000 healthcare workers, part of the Service Employees international union, the nations Largest Union behind the National Education association. While gray matter announced april 20 through would pay extra ten dollars an hour to nurses it has not extended the offer to other employees, said a housekeeper. We are all exposed to the same thing, set a father of three boys. I might not have to go into and touch residents to do have to go in there and sanitize and clean all of the things that they have. Grand manor did not respond to a request for comment. The home owner who is of chicago did not respond to request for comment. That is a nursing home my sister died in on may 1. Now, i want to ask particular perhaps eric carson about these Nursing Homes. The level of profit, how much support to the get on the states and the fed . There has those been a problem. They have the lowest paid workers in these people are doing the very best that they can and theyre going to stay on the job as long as they can, as long as as long as they domestically. What you know about the overall operation of the sourcing care homes . Thank you for that, congresswoman. Those are important questions. It emphasizes the need for federal policy to accountability from nursing home facilities. Nursing facilities are heavily funded through medicare and medicaid. Its the highest level of reimbursement by far for the nursing facility industry. In return for that its important there be accountability, that the money go to correct care staff as you know. The folks like mr. Brown, the nurse aides and the nurses who are their daytoday providing care. Its important there be accountability and that also there be accountability for violations as well so that the facilities are properly, experienced consequences for poorer care. Theres multiple reports that gl report i mentioned earlier but many others that demonstrate persistent core care and nursing facility. Some do a a really good job wih our many others who just year after year stumble along, provide essentially substandard care. Thats the status quo. Its important that those facilities, that the money go to direct care and not to the corporate entities that are set up to accept management fees. Thank you very much. The chair now recognizes mr. Jordan. Thank you, mr. Chairman. Mr. Kerpen, Governor Cuomo and the governors from the six other states you referenced did it exactly wrong, didnt they . Yes, they did. They put Older Americans infected with covid19 back in Nursing Homes, back with the most vulnerable and at risk population on our planet, is that right . Thats right. And it didnt come in the case of Governor Cuomo they didnt do it just a one day, two days, three days. Governor cuomo had this policy in place for 46 days, its at right . That is right. I mean, i think next to defunding the police, this may be the most ridiculous policy thing ive ever seen, policy decision ive ever seen from democrats. And any person sent from a hospital to nursing home was, in new york, was proven from the tested before the way back in the nursing home, is that right . They could not require a test, thats right. Theyre taking the most at risk people putting them in come back with the most at risk people and wouldnt let them be tested before they allow that to happen. This is crazy. As Ranking Member scalise pointed out, mr. Kerpen, this was a direct violation of cms nctc policies and guidelines, is that trip . Yes. When in history of the country come is any of the time what would say someone with another not culminating but another contagion disease, contagious illness could be sent back to a nursing home . I cant think of another example. Its very unusual. This is crazy. So the right decision you mention something earlier. Supposedly the recidivism was Hospital Capacity concern come right . Thats what they said but they were bored at the time they would have opposite effect. What happened was exactly. Thats common sense. Plus in the case of new york they had that comfort the navy ship part in the harbor. It made no sense. Maybe they mess up for a day or two but in the case again at the york they get did it for 46 da. 46 days to put the most vulnerable population at risk it a place where other of the most vulnerable population are residing. I just find that and they still will not give us on this number so we know how many of the deaths occurred in new york were among the nursing home population. Right. Well said. Some people did it right. The best example is when you pointed in your testimony is florida. Governor to santa said were not going to do that. Affect his what Governor Desantis did a photo. He said individual seeking to enter a facility under section one will not allowed to enter if you meet any of the screening criteria listed below. Heres what he put there. If they had been an airport or cruiseship, if the tested for negative coronavirus not once but have to test negative twice before they would allow to go back into nursing home, he put in place the right kind of policy and thats why the numbers in florida are so much better than in new york and the six of the state you referenced in your testimony. Is that true . Yeah, there are still a lot of deaths there which i think the point the professors making that you cant prevent this. This will happen everywhere but the skill of which it happens. Mr. Chairman, well, mr. Kerpen, you said earlier that the proper approach, the commonsense approach that is consistent with the data, what we should have done is isolate in quarantine this vulnerable population, not to do the acrosstheboard lockdown that so many states have done and, frankly, some states are still largely in a lockdown mode. We should have handled frankly the way georgia and florida and other states have done it. We would have been much better off. Right. Such a lockdown cost about 25 billion per day to the economy, a staggering sum, and where forcing people to sacrifice for no risk to themselves, that they might affect some older bulbar person but its same time were not putting the resources into directly protecting those people which we much more efficient. I agree with all that. Theres the Economic Cost but also the cost for doing it the wrong way, the cost of human lives. People die died because of decs that were made. Mr. Chairman, what we need is a need to hear from the governors of the states who did exactly the wrong thing at a special mre appropriate we heard from mr. Cuomo at some point about the decision he made and the wrong decisions he made that he had in place for a month and half with this vulnerable population. Thank you very much. Your time has expired. I now recognize ms. Maloney. Chairman, very important hearing. I want to briefly respond to the unfounded attacks i have heard today on my home state of new york. The facts are clear. During this crisis, americans have died in Nursing Homes in every state in the United States. In many states more than half the deaths from coronavirus occurred in Nursing Homes. Examples from ohio and florida, an estimated seven to ten corona deaths, seven out of ten corona deaths were in Nursing Homes. So this is not a red state or a blue state problem. It is a national problem, and we urgently need a national solution. And as for my home state, i agree her every new yorker who was lost his life in this crisis i agreed but im incredibly proud of new yorks response. Our state followed cdc guidance including on Nursing Homes, and what we lacked was strong federal support to get testing and personal protective equipment into Nursing Homes quickly to prevent the spread of the virus. And with that i would like to turn to my questions and i would like to remind everybody that it was on march 11 that dr. Fauci, the top Infectious Disease expert in our country, told us the truth at a hearing at an oversight committee. And he said back then that the United States is already failing on coronavirus testing, and he said, i quote, its failing. Its going to get worse and i regret to say that he was correct, but nowhere was his force that proven to be more accurate than in americas Nursing Homes. And with that i did like to really express i would like to really express my consider condolences for your loss, ms. Lolley, for what you and your family have gone through, and heartbreaking situation. And i am so sorry for your loss. But last month the Top Administration called for all nursing home residents and workers around the country, he called on come in the country to be tested for coronavirus within two weeks. But the administration left it up to states to acquire their own testing supplies. An analysis by the Associated Press indicated Nursing Homes and at least 25 states were unable to meet this testing goal. So dr. Grabowski, im interested in your perspective. Was the guidance from the administration sufficient to ensure that every nursing home had enough testing . Absolutely not. The guidance was not sufficient. Ive actually called it nonguidance guidance, in in that there were no teeth or dollars behind it. If you dont put logistics come if you dont put cost into this guidance, if it is simply a theoretical set of sort of guidance for the Nursing Homes and for the states, its not actually going to happen. Were seeing incredible variation as you mentioned in terms of what states are doing. For example, ohio is using the national guard. New jersey is requiring testing the pushing a lot of the logistics and the cost out to Nursing Homes. Alabama is that doing anything in terms of these requirements. Quite a bit of variation. I wouldve liked to seen federal leadership and federal not just guidance in your opinion what would an effective National Testing strategy look like . It would actually put dollars and logistics behind it. Theres Nursing Homes in a lot of states, even your home state, they cant get testing fast enough. They are struggling to find a test. The federal commission but put the testing in place and actually paid for it. For residents of Nursing Homes they can be covered through medicare, medicaid but many of the workers sort of caught in the middle of this. Some workers are able to get their testing covered through their insurance. Others are trying to get it paid for via the Nursing Homes but others are simply just left in between here there was a story yesterday in the New York Times of when worker making close to minimum wage went to go and pay for her own test. Thats not what we want. Lets have the federal government come in and owned this issue by paying for the test and arranging for the test in every u. S. Nursing home. Its clear brought testing a Nursing Homes with catch coronavirus cases early and stop the spread. This simple step would save so many lies. Mr. Chairman, we need a comprehensive National Nursing home testing strategy now. And i yield back. Thank you very much. The chair now recognizes for five minutes mr. Luetkemeyer. Thank you, mr. Chairman, and Ranking Member scalise. Appreciate the hearing today. Obviously this this is a tragey thats going on. We find that as a result of a lot of the studies that are being done over the last several months that this is a very targeted disease. It is targeting individuals at High Risk Health conditions in our seniors and many, many of them are a Nursing Homes and obviously when you cant read them all in one area they are all high risk, we wind up with the problems we have today. Its discomforting to me and come in our briefing notes we look at, i think i counted seven different guidance, directors, cms. With regards to our Nursing Homes could help themselves and their residents with regards to how they could do something for corralling the coronavirus in the own facility. It seems to me like its, if more guidance is needed thats fine but at some point somebody needs to take advantage of the guidance and actually do it. Mr. Kerpen, he gave a lot of her interesting and informative information. I certainly appreciate that. 55 if vince now are in Nursing Homes. Thats phenomenal, wow, off the charts. Kids are at less risk for flu, the regular, call within the regular flu. Thats an interesting number. Over 60 of deaths are from people over age 75. It is a targeted disease and as that information, one of the things weve learned that i think Going Forward is because this is a very targeted disease, i think that we should be able to target the disease especially if it is confined in Nursing Homes or to seniors or two folks in High Risk Health conditions to attack those and maintain a manager those in a way that could be, could minimize the risk as well as then open up the rest of society who is at less risk adjusted with the kids having less risk than the regular flu. Mr. Kerpen, would you agree with that statement, that we probably arent less risk for the rest of society, could open up pretty well. Was yeah, i think [inaudible] what would you say we need to do to manage better the Nursing Homes, the risk that isnt there, since i know theres been a number of folks give a lot of different ideas that im curious about your ideas with regard to how we would better manage this from the standpoint of if thats what the problem is that thats where we need our focus on . I think its having the focus match with the risk is which is to say we should not of national messaging that says everyone is at risk. The message needs to be really about who truly is at risk and thats with the focus needs to be. A time for the administration to set up a whole bunch of guidance to say these things and say, [inaudible] this is who is at risk at any speed the Major National focus that explains so people understand who is a lowrisk, high risk. I think that bessie is critical. In turn the policy of limitation i think there are generally adequate resources if the states prioritize correctly which is a some states have done a much better job. You dont need to be mass testing the general public and able to wants to walk up even if you have a sentence. You could be using the same test inside the Nursing Homes and other high risk populations a special inside the Nursing Homes. Several European Countries have stopped brought population testing completely and put all the testing and resources into the Nursing Homes. And may make sense for states to ship in that direction. The resources we have with the much better utilize in terms of wrecking them to work the risk is. But also in terms of sundays Big Government programs, things been suggested being put more money, paid basically, all this a conservative i wouldnt oppose but if we put these resources into Nursing Homes in exchange for opening up the low risk activities and communicating people. At risk that might be worth considering because the cost of the blunderbuss not locked out or so enormous and incommensurate with risk the what we can do to address the true high risk would be worthwhile if we can also open up for the low risk. We have to study, talking about i think last meeting with regards to the locked down and check them cost of 65,000 lives a month for the rest of society and were living much less than that on the covid side of the Balance Sheet which you dont think the ballgame, keeping score but by that same token you to focus way problem is and were having more and more people die on the other side. It is significant and needs to be taken a look at. One of the interesting things im curious as when the lockdown of Nursing Homes, and ms. Lolley, i empathize with your situation. My mother was a nursing over seven years and i know was in that are Nursing Homes that dont get good care and its very disconcerting but i just kind of, ask a quick question with regard to make the comment that you became less, you started to see her condition deteriorate [inaudible] i think thats a question i would be curious to see if you have that as, if you saw that as a problem . Did that caused some of her problems, you think . With not being able to interact with others in Nursing Homes . Even her family. Undeniable. The isolation and loneliness was a part of it but i genuinely believe that inside the nursing home where my mother resided, they were struggling with proper staffing. I believe that there were periods of time where my mother didnt see anyone probably all day except for food tray to be delivered, if that occurred. I really believe that her quality of care and continuity of care was compromise very early. Combine that with loneliness and isolation and having visits outside of a very dark screen under window with people covered with mask, it just me for horrible situation. Thank you very much. That chair now recognizes ms. Velazquez for five minutes. Thank you, mr. Chairman. I just first would like to make some comments against new york and other states in the nation. For blatant governors and paving states against each other to compete for gears resources will not [inaudible] take responsibility look, the stock market today are those who want to say that things are getting back to normal, no, its not getting back to normal. As chairwoman waters stated, we have states like montana, arkansas, utah, arizona and texas, all have seen coronavirus hospitalizations on the rise. What we lack is a strong federal support to get testing, personal protective equipment into Nursing Homes quickly to prevent the spread of the virus. That is why i lead a letter with lawmakers on both sides of the aisle called on the administration to direct Additional Resources from the cares act to these facilities. Those Additional Resources at ppe and testing, testing, will create safer conditions for our workers in seniors. Not artisan politics. So let me address my first question to dr. Grabowski. As i mentioned, i lead a letter calling on cms, on hhs to prioritize the 175 million in Healthcare Providers relief funds to Nursing Homes for ppe and testing. In your opinion, has the administration allocated those funds appropriately to support self care workers healthcare workers on the front lines in Nursing Homes . No, i dont think they adequately prioritize Nursing Homes. I hear from many of my colleagues at all levels with the nursing home saying they feel like theyre in the back of the line, that they are the last to get these resources. As weve all been discussing, this is where the cases are. This where the deaths are. This is where the attention and resources should be. And the states that he mentioned it today, arkansas, utah, all those estates that are now facing an uptick of hospitalizations, are they not following cdc guidelines . This idea that states policies that driving cases in Nursing Homes and deaths, its just not sort of whats going on on the ground. All of those dates have begin to see hospitalization undersea cases in the community, its going to be the fact that is going to end up in the Nursing Homes. Arkansas at the taxes, you may admit its going to happen. In massachusetts we never mandated that Nursing Homes accept individuals from hospital who were covid positive. Yet one if i Nursing Homes, over 80 facilities have that 20 deaths. Those are not deaths they came from the hospital. That was cases that started in those facilities for the most part. We want to be really clear about what kind of origin of covid in Nursing Homes. Its largely through staff bringing, unbeknownst to the staff into the building. Thank you. Mr. Brown, after the first Conference Call with making death any nursing home, it took osha nearly three months to issue guidance that would protect nursing home workers. What can we do at the federal level to ensure the safety of nursing home workers were the outbreaks are the worst . Thank you for your question. Theres a lot that could have been done during this time. It took them months for them to even bring in someone to sanitize and clean the building from covid19. And when we speak about earlier, ms. Lolley, sorry for your loss, she stated about the correct staffing. This is one of the main things that can be done with the talk about poor care. When you have one cna who is working and they have 15 residents, and when they receive the things they need to take care of these residents, they are given seven towels, seven diapers. I have 15 residents. Each resident needs be changed every two hours or as needed. Theres do with possible for me to be able to do what needs to be done. Im sorry for your loss, ms. Lolley, but everything she said, she hit right on the head. Staffing, staffing, staffing. Staffing needs to be given to us. So healthcare can be done appropriate the weight needs to be done. Outside of that, the appropriate ppe, i have to stress, these things are going on before covid. These were the problems before covid. There were always coming that had to protect myself from, hiv. Covid, the missing code is was ripped the doors open on the system that was already failing. From that, and from that we have ppe now but even if im going to the room at a change of the resident, if any of those things of the soiled linen or their feces get on that ppe, it soaks through that ppe and it still gets on me. Thank you. Thank you very much. Thank you, ms. Vasquez. Ms. Velazquez. Lets her know from his lusty. Ms. Lolley, i am so sorry about your mom. I am so sorry to hear about horrible, just horrible thing that happened with your mom. Im so sorry about thanks. The pandemic has affected the whole world [inaudible] nowhere is that [inaudible] we know that by race in close quarters. We know does most of us are convocations or even death from corona on the elderly and those with underlying conditions. Sadly, these facilities combine all the worstcase factors in one place. When nursing home owner in new jersey summed up the challenge as this. If you can dream about having zero cases, but it was the matter of when, not if it when he it gets into your building it hits hard and it is vicious. It doesnt give up for a second. The number illustrates the sad reality. Found nursing home residents make up only. 6 of the is population but account for 42 of the corona deaths. So i should know, mr. Kerpen, they couldve an even higher. This is a global challenge. This relatively small of the population accounts for 38 of corona deaths in england and wales, 49 sweden and 9 sweden and 82 in canada. Since the beginning of this crisis the Trump Administration has issued 13 different memoranda and guidance to assist states in Nursing Homes in protecting the residence. State should also be court, nady and from each other. For example, in my home state of indiana we are five minutes from the michigan line. Our governor dispatch medical experts to assist facilities like longterm care facilities with containment and logistics including separating positive patients on the general population as the nursing home owner earlier i quoted said its naive to think there will not be cases in Nursing Homes. There will. But this Rapid Response i am so glad our governor took that action and with much lower numbers. The overloading evidence makes it clear anybody can do is to knowingly induce coronavirus into a nursing home. And yet i was essentially the policy of states like new york and new jersey and five and smite district in michigan which mandated that nursing home admit patients who did test positive for coronavirus. So i think such an abject failure of policy should invite tough question for policymakers. Instead, heres what happened in the National Media. The National Media rewarded new York Governor Andrew Cuomo with a glowing endorsement and talk about being a president ial contender with Michigan Governor Gretchen Whitmer received Vice President shall buzz. The media with quick to condemn florida for opening its beaches. They condemn georgia and branded it as an experiment in human sacrifice. Yet after sending coronavirus patients into Nursing Homes full of vulnerable residents, Governor Cuomo is laughing it up with his brother in an interview on cnn, and pennsylvania top officials took their mother out of a nursing home assess it was forcing the host to take patience testing positive for coronavirus, and yet barely a peep from the National Media. That is the scandal. Whats the National Medias excuse for looking the other way . Its hard to say that got the ball with soma didnt even bother to pick it up in the first place. Thats why im so glad were having this ring today to be able to ask questions. Mr. Kerpen, just when ask you for your weve established, many of us have establish it but new york, new jersey and michigan did not follow cdc and cms guidelines in order Nursing Homes to accept positive patients for coronavirus. Seven states all have policies forcing these facilities to take patience with coronavirus for almost and longterm care population in the u. S. But i just want to ask about the data challenges. You said the new york numbers could be even higher if not for change in reporting in april. Can you describe the changes and how that might affect their countless are there any other states reporting their data like this or are they an outlier, mr . Through the end of april new york had a very incomplete report of the did at least notionally while the same try to count the same claim that id what else accounted which is number of longterm care resident reside [inaudible] they did a big revision of that a number but they started footnote saying this only includes residence who died in the facility. If someone is hospitalist first, died at the hospital, new york said hospital death and not including it on account longterm care residence. Nationally, about 26 of all covid deaths are at, physically at longterm care facilities which means most of longtermcare deaths this is why the real new york numbers thank you, sir. Time has expired. Thank you very much. That chair recognizes mr. Foster for five minutes. [inaudible] you need to unmute, mr. Foster. Mi audible . Yes. At the heart of our ability to protect Public Health and see if we open our economy, is accurate and timely data. We need data to know what cases are spiking which hospitals are risk of being overwhelmed in which Nursing Homes are in trouble and or medical resources should be allocated to say the most lives. We all know Nursing Homes have been especially devastated by covid. At one nursing home in joliet, illinois, in my district we lost at least 26 lives due to covid19 this spring, all caused by one super spreader, a Maintenance Worker with no symptoms the was not wearing a a mask because of the nationwide mask shortage, and he was not tested because weeks after trumps promised that the one who needs a test can get a test, there were no test available. Perhaps the work test, covid test available for occupants of the white house that there were none for nursing home workers in joliet, illinois. Now, cms is a federal Agency Responsible for ensuring that Nursing Homes around the country are safe. It is supposed to collect data and provide guidance and oversee inspections. With more than 40,000 40,000 as losing their lives in Nursing Homes, that job has never been more critical. However, i understand cms is not even collecting a complete set of data on the scope of the outbreak at Nursing Homes. This is on top of the decision made by some governors and not just the governor of new york to hide the nursing of data. Presumably because it did not like what the data set. Dr. Grabowski, why is it important for the federal government and the American People to have comprehensive data at americas Nursing Homes . Thanks. Good Public Health requires a good data, and similar to mr. Kerpen, my team has worked really hard to piece together the cases and fattah police in Nursing Homes going back to the beginning of this pandemic. Unfortunately cms was really late to this party. They didnt release the data until may and the data is incomplete prior to may 8. That really creates a huge hole in our understanding of covid in Nursing Homes. How do we know what is working across different Nursing Homes in different states and what is not working if we dont have the right data . So basically we have been flying blind with respect to covid in Nursing Homes. Cms has really left this huge hole in terms of the Historical Data back to the beginning of the pandemic in march. Mr. Carlson, i would like to turn to you. Cms is supposed to ensure that each a nursing home has enough staff and false appropriate Infection Control techniques such as wearing masks. Appropriate ppe and handwashing. And it is empowered to take action against Nursing Homes that have persistent or dangerous deficiencies. But as you mentioned a recent gao study found quote Infection Control deficiencies were widespread in process in Nursing Homes prior to the covid19 pandemic. As you mentioned, gao found 82 Nursing Homes have been cited for Infection Control and prevention violations over the past several years. So mr. Carlson, why are they still pervasive in Nursing Homes . One thing to note in talking about deficiencies is that the system generally records them as no harm, dont result in any meaningful penalty whatsoever. That allows in situations like those cited by the gao for these violations to continue year after year after year. There needs to be some meaningful enforcement so we dont just look at the report and say [inaudible] but we are able to and say this cant happen every year. We just cant let this happen. Obviously the consequences just cant be tolerated. If cms has taken federal standard Nursing Homes or services before and during the pandemic could we have uploaded some of the devastation were seeing an Nursing Homes . Thats sort of part of it. Theres this discussion, a lot of variables here, but better infection prevention, better staffing, those are certainly big pieces of the problem or big pieces of the solution, if those practices were to improve going for it. Thank you. The Trump Administration needs to provide stronger oversight Nursing Homes. The administration has to start collecting Critical Data and old Nursing Homes accountable when they fail to meet federal standards so we can help prevent more these unnecessary infections and deaths. Mr. Kerpen, i want ask a question for the record on the scientific basis of wise you at the religion people can affect older people with covid19. Seems to me thats pretty much a scientific fact, and i yield back. Thank you very much. That shared a recognizes mr. Greene for five minutes. Thank you, chairman clyburn and Ranking Member scalise and thank you to our witnesses today. Ms. Lolley, want to extend my deepest sympathies and condolences for your loss. Honestly, it sounds like some potential malpractice in the nursing home and a hopeful that your state inspectors are notified and digging into that. By now and it is clear elderly americans are much higher risk of covid, according to the cdc, eight out of ten deaths reported in the United States are in adults aged 65 and older. Tragically residence in Nursing Homes are particularly susceptible. According to cms data as a june 10 there than 95,000 confirmed cases among nursing home residents, who gave thousand 288 suspected cases, and cases, and 31,782 deaths. Theres a great risk covid posts Nursing Homes. The task force has taken protective steps at the onset of this crisis to protect Nursing Homes, residents and workers in early march the administration advised Nursing Homes to suspend all medically unnecessary visits to help slow the spread. The administration also prioritize the shipment of ppe and supply to the systems whether critically needed. As of june third, fema made 9262 deliveries of medical supplies to Nursing Homes in 50 states and three territories. Additionally fema is correlating to shipments that total 14 day supply of ppe for all 15,400 medicaid and medicare certified Nursing Homes. Many states have stepped up to the plate as well. I home state of tennessee has been working night and day to protect our most vulnerable neighbors. In march we began requiring all nursing and two other date and Health Officials at the detected two or more case of the coronavirus among residents or staff. Enable the the department rollt an hour by hour action plan for Nursing Homes to help stop the spread and mitigate outbreaks. Unfortunately that every state did it the right way. Some states completely failed the Nursing Homes and, of course, we talked about new york being a prime example. Other members have already hit the failure of several governors to follow cdc guidelines and president trumps task force guidelines, and resulting deaths. Id like to take a few seconds and code some of those leaders, some of those governors, overall flippancy about the virus in the first place. In february this bite the coronavirus across the globe, Governor Cuomo lately dismissed the coronavirus and told state citizens and a quote catching the flu right now is much greater risk than anything that is in thing to do with coronavirus, end quote. The mayor of new york city, clearly ground zero for the United States, bill de blasio, follow suit and tweed on march 2 march second m march 2, thats a full month in three days after the president close travel from china, mayor de blasio said, at the quote, im encouraging new yorkers to go on with our lives. It out on the town, despite coronavirus. Unquote. And then suggested residents go to the theaters and the movies. Nowhere was this nonchalant attitude more deadly than in new yorks Nursing Homes. On march 21 the stakeholders held they did need to test symptomatic residents. That led the overall testing in being in the Nursing Homes completed. Later in march new york ordered Nursing Homes to admit nations regardless of their covid19 status, which was a recipe for disaster. Many new york Nursing Homes were Self Reporting and in the build to safely take in those residents. The state effectively forced understaffed Nursing Homes to violate cdc guidelines. Further, the state prohibited Nursing Homes from testing a resident for covid19 prior to admission. This wasnt just bad leadership. That killed people. Governor cuomo didnt reverse his order to force covid patient back in the Nursing Homes until nearly two months later, as has been said. Other states like michigan still have it reversed that order today. As as a result of the volunteer states proactive steps, and new yorks failure, you can see the disparity. Tennessee is 12. 1 coronavirus cases from 1000 nursing residents while new york has 111. 111. Weve had 3. 6 best per thousand residents while new york has a 3. 9, over 12 times as many. These are not just statistics. These are human lives. The vast majority of the deaths in this nation are elderly with the vast majority of those totally dying in Nursing Homes. And the vast majority of those die in Nursing Homes in the seven states who blew off the cdc and the President Task force. That paint a pretty clear picture of where this committee needs to direct its oversight like like a scope, and i hope we will. A quick question for extended time. I will allow the question. Thank you. Just a quick question for mr. Kerpen get any reason why the michigan governor will not reverse this . Our colleagues come her fellow colleagues have of the democratic governors have reverse this bad decision to why she continued . Shes in a bit of a political sort of tugofwar with republican legislators want to revoke some of her emergency power and she seems to be holding up altering the nursing home policies as sort of part of that backandforth would be my best guess. I dont think theres a very good policy reason. Thank you. Thank you very much. Mr. Raskin is is now recognizer five minutes. Thank you, mr. Chairman. The egregious failure of the Top Administration to develop a coordinated National Strategy to combat the covid19 virus in Nursing Homes is just a tragic microcosm of lethal failure to develop a comprehensive National Strategy to defeat the covid19 crisis in the United States of america. America now leads the world in cases of infection and deaths from the disease. We now have more than 108,000 people that weve we lost in ts nightmare, although youll never hear any of our colleagues mentioned that number. And still the Top Administration has no nationwide strategy or plan for testing Contact Tracing and boxing in the virus. Where is the plan . When the Obama Administration confronted the ebola crisis, he appointed of czar, ron klain, and up a nationwide plan to defeat the ebola virus. We lost two americans, and the republicans still denounced president obama and railed about his incompetence and call for his resignation. This crisis is more than 50,000 times worse. And counting. Today the Ranking Member, mr. Scalise, our colleagues on the other side fine other some official governmental responsibility. For dealing with the crisis. Todays gop robotic talking points are not about the World Health Organization or about the Chinese Government or Donald Trumps very good friend from the Chinese Communist party, todays official talking points are about actual u. S. Government officials. Thats progress but what do you know, if democratic governors and mayors that theyre blaming for the crisis today. How ignorant do they think americans are . It took more than two months after the first outbreak in a nursing home, and one of the first one was in my district were more than 100 people were sickened and we lost 28 people. But it took more than two months after the very first outbreak for the Top Administration on may 11 simply to urge residents and staff of Nursing Homes to be tested. It was just words saying you guys should be tested, and are still no nationwide testing plan, Contact Tracing plan, enforcement plan. Its just talk, just rhetoric. For months, Nursing Homes lead for ppe and testing kits from the federal government and received nothing. A couple of photo ops and submit assistance from the federal government. In late april fema announced it would coordinate the shipment of a cubic supply of ppe to Nursing Homes. Great. It hopes the supplies will arrive at the beginning of july. This is the country that defeated fascism in world war ii. This is a country that sent men to the moon and the federal government seems completely inapt and helpless. Dr. Grabowski, mr. Kerpen repeatedly referred to people were not at risk from the virus and also suggested that the stayathome orders that were issued to both republican and democratic governors like my republican governor of maryland, larry hogan, were unnecessary. What ive read Scientific Data suggesting that those are the only things thats working to save millions more people from being able to be infected and tens of thousands more deaths. Which is correct if you could clear that up for . Absolutely. So the lockdown certainly latin of the curve in many states, and did save a lot of lives. And indeed you can imagine the discussion will be having today about our nursing home residents and their staffs if we have not had the lockdown, and this would allow us to run unfettered through the community. We can do anything to invest and protection Nursing Homes to allow the escalation of cases in the community. It would be even more dire than the discussion we are having today. Thank you. Mr. Brown, Staff Shortages that have arisen at Nursing Homes of longterm care facilities, know a lot of people are being paid 14 or 15 an hour hour. I dont know exactly what you earn but its just above the Poverty Level that people are being paid. Can you describe why there are shortages of staffing . Is it just because its hard to recruit people to do this difficult work . How do you explain it . Thank you for your question, thats a good question. One point i can say is when it comes to hiring these people, i can speak to like this. When covid19 broke out, my brother is a cashier. Anybodys job is equally as effective at them and covid broke his job raised him up to 18 an hour. At the time i was at 13. 90. We are expecting people to come to work and put their self at risk for a pace that is not worth it. We people under building that have been working there for four years, they retire their retirement check will be less than 150. So when we speak to keeping staff in the building, we are not going to do that when were not paying them what theyre worth and were calling these people he rose. Thats not to cut it. Not having the testing in the building, i still not been tested. I dont know if i have covid or if i i had covid or whatever te case may be. Im still coming to work and still working with these people. I couldve passed to come i dont know because theres no way for testing. We talked about keeping staff in the building, currently right now the government did pass something to allow cdnas to come in the building and help but that doesnt cut it because you dont have the education or the background nor passing the state board to be job or doing to do it effectively and correctly, theres a lot of things they cant do. Yet they can pass trade but they cant feed people pass trays. You have to make sure theyre swallowing, not giving into much, much of the food come knowing those types of things. They are bringing in and train people for the help that its not helpful because they cant change, they cant feed all they can do is pass trays. So what needs to happen if you want more staff, better step, people go to school have to take a state board for this. They need to raise up the pay that these cnas are getting. I can go to mcdonalds akaka programming more and im making that taking care of doing the backbreaking work of taking care of somebodys family member. Thank you very much. Thank you, mr. Raskin. The chair to recognizes for five minutes mr. Kim. Thank you, mr. Chairman. Appreciate you calling together this briefing. I wanted to start with the question for mr. Kerpen. You talked about several states and a policy decision made with regard to transfer patients to longterm care facilities, if these patients may have been positive with coronavirus. In the states how many coronavirus positive patients or patients that had coronavirus were actually transferred to longterm care centers . How did the additional positive cases warrant a result of those transfer . , of those, of these cases that we saw in the seven states responsible for the title have data on that. I have seen in reports. I have seen any states report the numbers that way but that would be interesting hated to have. I agree with you on that. Im a data guy as well. You want to make sure were thinking through this to understand what the causality is. What do we actually know . What we know is from a longterm care centers i talked to a district as well as what we heard iraq is we know they did not have enough personal protective equipment. We can trust the line between causality there. Mr. Brown, i wont ask you, you said you didnt have ppe before for yourself or your coworkers here now i would like to see right now to have enough right now . You have enough guarantees right at any bit of a second wave of this virus . In the second wave . No. We dont have enough for a second way. If the ppe where getting is even effective because as vested before i can go in and do the care, that ppe gets wet and it still gets on my clothes. Mr. Carlson, you have a Wider Perspective here across a lot of different longterm care centers. Have you known of any longterm care facility that had enough ppe during the height of this epidemic . And you think they have enough right now to be able to prepare for a second wave . Its possible there may be some facilities out there that have been adequately supplied, but in general i think the panel has failed unanimous on this question that there hasnt been enough ppe in the system. It hasnt been distributed in a comprehensive manner, and i submit that shipments of fema, from fema have been a bit late and inadequate. So i cant speak to of the facility, but certainly systemwide theres been a tremendous problem even to the extent that they have ceased activities a lot of cases that the state surveyors specifically note that they would only do infections if they had adequate ppe, and oftentimes they recognized recognize that they dont and so as a result they curtailed their activities. Thats helpful. A large trend, not having enough ppe or still potentially having especially in face of the second wave. Dr. Grabowski, i wanted to ask you, we know we dont have enough ppe. We know we didnt have it. We still have enough. Another area where ive seen pretty widespread consensus here is we dont have enough data, that were struggling to be able to get it. I would love to what is it were missing . Absolutely. The federal government put a lot of resources into putting together what they thought would be a comprehensive covid database of cases and deaths but the missing piece is they made it optional for facilities to report cases and deaths prior to may 8. Thats not useful because as we were talking up their states like new york and new jersey have had a tremendous number of cases so thats a big hole. We are waiting on about 20 of facilities to report their current data. The final point where having about a lot of data errors and lots of facilities that have values that just dont with experiences of family members and staff that are working in those buildings. Thank you. I just want to make sure were following the causality correctly. Other standards of ppe, of the lack of data and ms. Lolley talked about the lack of communication and staffing issues all coming together and i think some other issues that will raise, we need to see more data to draw the line. But dr. Grabowski, just wanted to follow and into with you. You had a link in your statement that it was very it didnt have to be this way. I agree and i wanted to just ask him who is fundamentally responsible for responding to this crisis, the federal government or the state . The federal government. This has to be an issue that the federal government owns in terms of testing, in terms of equipment, in terms of support for our workforce. The buck has to stop there and it got pushed off to the states are pushed off to Nursing Homes. Weve had far too many gaps here, and Going Forward this is the time for the federal government to own this really together, comprehensive response. Great, thank you. Thank you, mr. Chairman. Thank you very much, mr. Kim. Before closing, the chair would recognize the Ranking Member for any closing comments he may want to make. Mr. Scalise . I think you are muted. They just unmuted me. Are we on . Thank you, mr. Chairman. Again thank the witnesses for their testimony, and im glad we finally got to start getting into talking about the data. Theres a lot of data out there. Frankly, there still some states that are not getting as a data we need and we are called on new york and other states. Theres a letter to the talked about in my Opening Statement that i like every member to sign off on to ask for that data to get more information because we had seen while this diseases out there throughout the country and its impacted so many different areas, seniors in Nursing Homes have been by far the most disparately hit. More people how we can get the economy back open safely but there is still seniors dying in Nursing Homes and it boggles the mind and people talk about that. Look at the order from the governor of new york in march, Nursing Homes are prohibited from requiring prohibited from requiring testing. Thousands of people died. Fortunately the governor of new york rescinded this but as mister jordan talked about, 46 days, thousands more people died. Nobody not a member is disputed that these were deadly orders, nobody said these were good orders for the governors to give yet they gave these orders, new jerseys language almost verbatim from what we saw in new york, nursing facilities are, quote, prohibited from testing. Michigan, this is the worst because not only did they prohibit that but they are still doing it. We ought to have the governor of new york talk about what happened, why they arent sharing data with us so we can make better decisions to help share information and stop more death. We are to have the governor of michigan talk about why she wont reverse this. Of this about being stubborn because they gave in order and dont look like they did the wrong thing people are dying in michigan for no reason. It needs to end. Lets call that a bipartisan initiative. Who cares whose idea it is, we know the circumstances because we have the data and people are dying from these orders will be could bring in the governor of florida to talk about what he did following cdc guidelines, there are 14 different guidances, 13 times, cms helped Nursing Homes in states figure out how to do it, Nursing Homes have always been run by the states, not something the federal government, states do this and they have guidance, 14 sets of guidance, most people followed it. Republican and democratic governors alike followed it except some didnt follow it. Why they didnt follow but i dont know. We are to find out because people died. Thousands of seniors in Nursing Homes died for no reason because that guidance wasnt followed. We are to find out about that. I will yield back. I think the Ranking Member. I thank all our panelists for being here and paying attention to this tragic situation as it continues to unfold. We are grateful for sharing with all of us. I want to extend my condolences to you and your entire family on the tragic loss of your mother and extend special thanks to chris brown. You are one of our nations heroes and we are grateful for all you do to care for and protect our nations most vulnerable residents. I think Mister Scalise and colleagues for their participation and contributions today. I know you share my deep concern and sadness about what is happening in our nations Nursing Homes. Todays briefing made clear there are steps we can take now to prevent the tragedy from getting worse. First we need the federal government to ensure our Nursing Homes have enough testing and personal protective equipment to stop the virus from spreading. That means providing coordination and resources not just leaving it up to the states. Second, we need strong oversight of Nursing Homes, to ensure better Infection Control and enough staff to care for our residents at all times. Third we need to make sure essential workers have paid leave and i might add testing so that they are not forced to show up at work sick. Weve seen far too much suffering at Nursing Homes during this crisis. Time to come together, to bring this tragedy to a end and i would hope in spite of all that i have pleaded for the fact still remains we need to get beyond partisan politics, the statistics coming out of new york or texas or utah, florida or arkansas. The fact still remains this virus knows the color of no state. This virus knows nothing about which party you may be a member of. We could hear from the governor of new york but nobody calls today for the governor of texas and ive seen the numbers coming out of utah. Im not interested in anything partisan in this or arkansas. This is about us protecting americans irrespective of stations in life, irrespective of skin color, irrespective of party affiliation. We are all one america and lets try to act that way and i close this briefing. Thank you. House, science, space subcommittee holds a hearing on efforts to repurpose therapeutic drugs to help covid19 patients. Watch live at 1 30 p. M. Today on cspan2, online, cspan. Or listen live on the free cspan radio apps. Live this saturday at 10 00 am eastern, Poor Peoples Campaign rally, online gathering of people from across the country speaking out against social injustice. Speakers include activist cornell west, actor danny glover, comedian wanda sykes, actress deborah missing, former Vice President out gore and his daughter and actors and activist jane fonda Live Saturday at 10 am eastern. The Poor Peoples Campaign rally against social injustice on cspan, online, cspan. Org or listen live on the free cspan radio apps. This november we are going to take back the house, we are going to hold the senate and we are going to keep the white house. Donald trump returns to the campaign trail saturday for a rally in tulsa, watch our live coverage starting at 8 00 pm eastern on cspan, on demand, cspan. Org or listen on the go with the free cspan radio apps. Next, labor secretary eugene
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