Partisan or not, questions about Pa., N.J. nursing homes deserve answers | Editorial

Donald Trump’s Department of Justice is taking an interest in the civil rights of nursing home residents. Given the disproportionate toll the pandemic has taken on this population, that interest is warranted — but it remains unclear whether the interest is selective, or worse, politically motivated. The feds want information about how public elder-care facilities in four states governed by Democrats — Pennsylvania, New Jersey, New York, and Michigan — have handled the spread of the coronavirus. The DOJ announced the move in a press release Aug. 26, midway through the Republican National Convention.

Much of the material requested relates to the fact the four states issued directives requiring homes to admit COVID-19 patients who were medically stable enough for discharges from hospitals. The DOJ claims this may have resulted in the deaths of thousands of nursing home residents.

Nursing homes have accounted for about 40% of COVID-19 deaths nationwide, even though their residents comprise less than 5% of the American population. This startling fact alone suggests that efforts to get to the bottom of the tragedy should not be dismissed — regardless of whether Democratic governors in the presidential election year swing states of Pennsylvania and Michigan are being targeted for partisan purposes.

Health officials in Harrisburg and Trenton say their directives aimed to ensure the availability of hospital beds for an expected surge of COVID-19 patients, and that they also generated guidelines for protecting other patients and staff in facilities. The officials also say their actions were in accordance with guidance from the federal Centers for Medicare and Medicaid Services.

» READ MORE: The Justice Department is mulling a civil rights investigation into COVID deaths at Pa. and N.J. nursing homes

GOP elected officials nationwide have been raising questions about the directives for months. The fact is that in Pennsylvania, New Jersey, and many other states, the pandemic has laid bare a slapdash elder-care system. Underfunded by Medicaid and undermonitored by the states, facilities can vary widely in adherence to basic hygiene standards — and are often understaffed by underpaid and undertrained employees. Advocates say those on the front lines of nursing homes continue to face shortages of personal protective equipment.

Advocates and some officials have long tried to raise awareness of challenges that face nursing homes. Last year, Pennsylvania Auditor General Eugene DePasquale warned that facilities are unprepared for projected increases in patients as the state’s population ages. A recent New England Journal of Medicine story cited “decades of neglect of long-term care policy.”

» READ MORE: Pa. leaders should heed new report’s warnings on COVID-19 nursing home disaster | Editorial

A new report on Pennsylvania nursing homes by Community Legal Services of Philadelphia, the Center for Advocacy for the Rights and Interests of the Elderly (CARIE), and six other organizations made 42 recommendations for “immediate action” to address the COVID-19 crisis in Pennsylvania nursing homes. Among the recommendations: Higher pay and more training for staff, as well as more rigorous inspections and monitoring. New Jersey health officials say they already have implemented 19 of the many dozens of recommendations made in an analysis of the state’s response to COVID-19.

The DOJ has not yet decided whether to open an investigation. The toll of COVID-19 among nursing home residents is so awful that concerns about timing, targeting, and politics should not distract from the larger reforms that are needed right now.