Biden spokeswoman: Pandemic 'exposed what a problem we have on our hands' in U.S. nursing homes

Apr. 24—The pandemic shined a spotlight on problems that plagued low-performing nursing homes scattered across Western Pennsylvania and the rest of the nation long before covid-19 struck the United States, White House press secretary Jen Psaki acknowledged Friday.

As vaccinations ramp up and covid-19 hospitalizations go down, the Biden administration intends to learn from persisting issues that the pandemic exacerbated and made more visible in the past year — including the likes of severe staffing shortages, lax oversight, poor infection controls and nontransparent owners — and identify ways to improve the long-term care sector going forward. The coronavirus disease has claimed the lives of nearly 180,000 nursing home residents, including more than 13,000 in Pennsylvania, state and federal data show.

"There's no question from the president's standpoint (about) the impact on seniors that we've seen happen in facilities around the country, especially in the early days of the pandemic — when there clearly weren't the preparations in place, when there weren't the systems in place, when loved ones couldn't even engage with or reach their members who were staying in senior care facilities," Psaki told a Tribune-Review reporter tuned in virtually to the daily White House briefing held midday Friday. "It exposed what a problem we have on our hands."

White House opens up briefings to local newsrooms

The Trib was chosen to participate in the briefing as part of a new effort by the White House to include regional and local reporters who are not based in Washington, D.C., via a virtual seat every other Friday.

The Trib asked about what President Biden and his leadership team plan to do to address the longstanding shortcomings confronting nursing homes.

How can we make sure the federal government, states and owner-operators are all doing what they should be doing to improve the level of care, even beyond covid?

Complex webs of private equity owners and shell companies increasingly are snapping up cash-strapped nursing homes nationwide, making it difficult to follow where each facility's taxpayer dollars are going and to know whom to hold accountable for decision-making.

Bills aimed at improving care and transparency in skilled nursing facilities have bipartisan backing from the likes of Pennsylvania Sens. Pat Toomey, R-Lehigh Valley, and Bob Casey, D-Scranton, but most have languished in Congress for years. The pair joined other lawmakers in renewing their push for such a legislative package this past fall.

"Certainly, we will look forward to taking a look at that (legislation) more closely," Psaki said.

The press secretary did not elaborate on specific bills or oversight actions that may be in the works.

"In terms of (federal) regulatory actions, I'm not in a position to get ahead of that. I'm happy to see if there's anything underway that we will be able to speak to ..." Psaki told the Trib. "But I think you have clearly identified a challenging issue that is not only a problem in Pittsburgh and in Western Pennsylvania and parts of Pennsylvania, but we're seeing in states across the country as well."

In one of the more egregious local cases under scrutiny, a federal grand jury investigation is underway into owners linked to nursing homes Allegheny, Beaver and Westmoreland counties as well as nationwide. The probe began at Brighton Rehabilitation and Wellness Center in Brighton Township, where at least 76 residents died of covid-19 and more than 300 were infected.

A Tribune-Review investigation into Brighton Rehab, published Aug. 9, recounted a litany of infection control and other deficiencies and violations that happened during the pandemic, as well as others that have persisted for years. The Trib found those problems were exacerbated by a lack of communication, transparency and oversight from hard-to-find owners and by ongoing attempts to silence nursing home employees as well as residents and their family members from voicing concerns.

The federal grand jury is investigating the owners of Brighton Rehab, who also have ties to Mt. Lebanon Rehabilitation and Wellness, where a former administrator was indicted in February on charges of forging records to make staffing levels appear higher than they were. Attorney General Josh Shapiro has said more arrests linked to the investigation and others into nursing homes malfeasance are pending.

Under the Trump administration, former U.S. Health Secretary Alex Azar used Brighton Rehab as an example when he questioned whether states such as Pennsylvania are doing enough to flag bad operators and enforce corrective action plans. He said the Centers for Medicaid & Medicare Services was stepping up its own investigations and penalties as needed.

It will take a combination of state and federal efforts to resolve challenges on several fronts, Psaki said.

"It's not just one or the other," Psaki said. "There are responsibilities that the state has because there is certain funding that goes to the states to deploy in a lot of these areas, but there's also responsibilities of the federal government to work across different states and see these challenges that are happening, (and) what we can do to be better prepared, what we can do better for our seniors, what we can do better for the standard of care. ... It's really a partnership of both moving forward."

Next vaccine hurdles

With more than 50% of adults at least partially vaccinated and roughly 28 million vaccine doses being delivered each week, demand has eclipsed supply as the constraining factor to vaccinations in much of the country.

Echoing Biden's remarks in a White House speech on Wednesday, Psaki spoke about entering a "new phase" in the federal vaccination effort that relies on increased outreach to Americans to get their shots.

The next hurdles include getting the vaccine to more people "where they are" and driving down vaccine hesitancy rates in order to reach herd immunity, or the point where the virus will stop spreading rapidly across communities. Most experts suggest it'll take vaccination rates of at least 70% to get there.

As the vaccination program progresses, the administration believes it will only get more difficult to sustain the current pace of about 3 million shots per day. Roughly 130 million Americans have yet to receive one dose.

Surveys have shown that vaccine hesitancy has declined since the rollout of the shots, but administration officials believe they have to make getting vaccinated easier and more appealing, particularly among young adults.

Earlier this week, Biden announced a tax credit for small businesses to provide paid leave for those getting vaccinated or potentially needing to take time off to recover from side effects. Paid for through the $1.9 trillion virus relief package passed last month, the tax change would provide a credit of up to $511 per day, per employee for businesses with fewer than 500 workers to ensure that those workers or businesses don't suffer a penalty by getting vaccinated.

Biden's first presidential trip abroad

Earlier Friday, the White House announced Biden will be making his first overseas trip since the pandemic began.

The president will travel to the United Kingdom and Belgium in June.

"This trip will highlight his commitment to restoring our alliances, revitalizing the transatlantic relationship, and working in close cooperation with our allies and multilateral partners to address global challenges and better secure America's interests," Psaki said.

President Biden will attend the G7 Summit in Cornwall, U.K., which is happening from June 11-13. While there, "he will reinforce our commitment to multilateralism, work to advance key U.S. policy priorities on public health, economic recovery, and climate change, and demonstrate solidarity and shared values among major democracies." He will also meet with British Prime Minister Boris Johnson.

From the United Kingdom the President will travel to Brussels, where he will participate in the NATO Summit on June 14.

Next week, Biden will deliver his first joint address to Congress, then head to Georgia for a rally to promote his infrastructure package on his 100th day in office.

The Associated Press contributed.

Natasha Lindstrom is a Tribune-Review staff writer. You can contact Natasha at 412-380-8514, nlindstrom@triblive.com or via Twitter .

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