Findings

Congress finds the following: (1) According to the National Center for Health Statistics of the Centers for Disease Control and Prevention, an estimated 1,300,000 individuals resided in nursing homes in 2020 at the onset of the COVID–19 pandemic, and nearly half of all nursing home residents were living with a diagnosis of Alzheimer’s or other related dementia. (2) Regulations issued pursuant to subtitle C of title IV of the Omnibus Budget Reconciliation Act of 1987 (commonly known as the Nursing Home Reform Act of 1987) (Public Law 100–203) established basic rights and services for residents of nursing homes, including the right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. (3) In March of 2020, the Centers for Medicare & Medicaid Services instructed nursing facilities to restrict visitation for all visitors and non-essential healthcare personnel and cancel communal dining and group activities. Long-term care ombudsman program representatives and State surveyors were among those whose access to long-term care facilities was prohibited or extremely restricted despite reopening guidance released by the Centers for Medicare & Medicaid Services in May of 2020. (4) Many long-term care residents declined dramatically or died prematurely from failure to thrive in isolation. (5) According to the National Consumer Voice for Quality Long-Term Care, in the first year of the COVID–19 pandemic, 1 in 5 healthcare workers resigned, retired, or were fired. This exacerbated the longstanding problem of staff shortages that already existed. Lack of staff, combined with the forced absence of families, many of whom provided informal care and support to residents, resulted in a significant decline in residents’ health and well-being. During the pandemic, pressure ulcers in nursing home residents rose by 31 percent, the number of residents experiencing significant weight loss rose by 49 percent, the number of residents reporting feeling down, depressed, or hopeless rose by 40 percent, and the number of residents prescribed antipsychotic medications rose by 77.5 percent. (6) According to the Department of Health and Human Services, loneliness and isolation, such as that experienced by long-term care residents during the COVID–19 pandemic, represent profound threats to an individual’s health and well-being. (7) Essential Caregivers provide supplemental care for their loved one, regardless of staff shortages, staff turnover, or emergencies. Essential Caregivers support residents and advocate on their behalf.