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Medicare cuts to seniors in nursing homes during COVID-19 is unfathomable


Americans living in nursing homes during the last several months face the greatest health challenges residents of these facilities have ever experienced.

COVID-19 has changed everything. It has caused heartache for families who have lost a loved one or have not been able to visit a parent or grandparent. For residents who are recovering from the disease, there can be months or years of rehabilitation in front of them.

Yet the Centers for Medicare & Medicaid Services (CMS) is cutting funding for care to nursing facility residents, even though CMS was taking unprecedented action to protect the health and safety of our nation’s patients and the providers of their care in the wake of the initial coronavirus outbreak.

There could be no worse time to slash services. People living in nursing homes are among the most vulnerable populations who continue to be at risk for COVID-19, because of their advanced age and likelihood of having underlying conditions.

Unfathomably, beginning on Jan. 1, 2021, CMS has proposed cuts to Medicare’s financial support that underpins these patients’ care. The cuts sought by CMS are significant and deep and will have a damaging effect on nursing home residents’ access to rehabilitation, physician services and diagnostic testing. For nursing home residents who need care, these cuts will result in less physical therapy to build up strength, potentially depriving them of the full benefit of relearning how to walk.

A real example of the consequences is an 82-year-old man named Michael who lives in Northern California. He is a resident at a skilled nursing facility receiving therapy services. Michael was admitted to the facility in May, following a stroke and started occupational, physical and speech therapies as part of his recovery. He was making strides. In August of 2020, he was sent to the hospital with hypoxia and confusion and was diagnosed with COVID-19 and pneumonia. When he returned to the facility, he was not able to walk or take care of himself and began occupational and physical therapy four times a week. Despite his set-back, with just two months of therapy, Michael has gained the confidence and the ability to walk and care for himself with assistance. But he needs additional therapy that may end or be very limited in a few months because of the CMS cuts.

He isn’t alone. On average, nursing home residents are 85 years old or older. They have weaker immune responses and, many times, are diagnosed with multiple health conditions. Many are living with some form of cognitive decline including dementia. The continued herculean efforts undertaken by nursing facility staff, rehabilitation therapists and other health care personnel to care for patients with COVID-19 and prevent the spread of this virus is truly amazing.

The cuts CMS is proposing are at a great cost — hindering care for older Americans who live in nursing facilities. The cuts will create barriers to residents receiving care. The CMS plan would essentially reduce occupational therapy services to residents such as Michael — ending his path to relearn everyday necessities, such as how to keep his balance while carrying items and caring for himself.

And the cuts won’t stop there. They will impact the help he and other residents receive from speech language pathologists, so they can speak to their grandchildren again after a stroke, and even getting x-rays when needed.

These services are essential, and for many residents, allow them to return to independence. This is what we all want, what Michael needs and wants, and in the long run is less costly for the federal government.

Too many times seniors are overlooked by our society. Don’t let Michael’s story be another example of that painful reality. Health care providers serving nursing facility residents cannot sustain cuts of this size, and we cannot risk a decrease in important care for our patients. And during an ongoing pandemic is not the time we should have to worry about our older, vulnerable loved ones losing critical health care services.

Cynthia Morton, MPA, is the executive vice president of National Association for the Support of Long Term Care (NASL), a non-profit advocacy group representing ancillary service providers and suppliers in the long term and post-acute care community. Follow the organization on Twitter @NASLdc

Tags Caregiving Centers for Medicare and Medicaid Services coronavirus pandemic COVID-19 Elderly care Geriatrics Health care Independent living Medicare Medicare cuts Nursing home Occupational therapy

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