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The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) recently released a report showing nursing homes in the U.S. continue to see a rapid decline in new COVID-19 cases thanks to initial vaccine allocations prioritized for nursing homes and called on Congress to consider the industry’s 

 to address systemic issues facing the nursing home sector and prevent another COVID-type crisis.

Recent CMS data shows that nursing homes have seen a 96% decline in new COVID cases among residents since the peak during the week of December 20 of last year when there were more than 30,000 new resident cases. Along with the lowest number of new COVID cases, AHCA/NCAL’s new report shows COVID related deaths in nursing homes declined by 91% since December 20, 2020, according to a release.

“We are not out of the woods yet, but these numbers are incredibly encouraging and a major morale booster for frontline caregivers who have been working tirelessly for more than a year to protect our residents,” said Mark Parkinson, president and CEO of AHCA/NCAL. “This trend shows that when long term care is prioritized, as with the national vaccine rollout, we can protect our vulnerable elderly population. Now we need Congress to prioritize our nursing homes for the long-term by considering the initiatives in the Care For Our Seniors Act to improve the quality of care for our residents.”

AHCA and LeadingAge, recently released the reform agenda, the Care For Our Seniors Act, to address long-standing challenges affecting the quality of care provided in America’s nursing homes. The organizations say the COVID-19 pandemic has exposed and exacerbated systemic issues impacting the nursing home sector, such as workforce shortages, aging physical plants and underfunded government reimbursements for care.

According to the releasee, the Care For Our Seniors Act focuses on four key areas for improvement, which include enhancing the quality of care with enhanced standards for infection preventionists, requiring that each nursing home have a registered nurse on-staff, 24 hours per day and requiring a minimum 30-day supply of personal protective equipment in all nursing homes. The initiative also calls for a multi-phase, tiered approach to attract, retain and develop more long term care professionals leveraging federal, state and academic institutions.

While recommending several new ways to improve oversight and processes to support better care and protect residents, the Care For Our Seniors Act also aims to modernize nursing homes by looking at how the industry could shift to more private rooms, promoting resident privacy and supporting infection control best practices.

AHCA and LeadingAge say the reform will be costly, but is long overdue. The nursing home sector has been facing a financial crisis for years even before COVID due to low Medicaid reimbursements, the primary coverage for nursing home residents. The 

 calls for an increase in federal Medicaid funds provided to states and bringing the Medicaid rate up to equal the cost of care. Currently, Medicaid only covers 70 to 80% of the costs to care for a nursing home resident.

“With a growing elderly population soon needing our services, the moment is now. We must pay tribute to all those who lost their lives to this vicious virus and resolve to bring forth a brighter future,” Parkinson said. “We have already seen what progress can be made when policymakers come together to make long term care residents a priority and through these reforms, we can significantly improve the quality of care for our current residents and generations to come.”

Articles

As COVID-19 cases in nursing homes decline rapidly, the healthcare industry calls on congress to take on needed reform to address systemic issues facing industry.

Nursing Homes See 96% Decline In COVID Cases Since Vaccine Rollout

University of Maryland School of Medicine (UMSOM) researchers have identified the most toxic proteins made by SARS-COV-2—the virus that causes COVID-19 – and then used an FDA-approved cancer drug to blunt the viral protein’s detrimental effects. 

In their experiments in fruit flies and human cell lines, the team discovered the cell process that the virus hijacks, illuminating new potential candidate drugs that could be tested for treating severe COVID-19 disease patients. Their findings were published in two studies simultaneously March 25 in Cell & Bioscience, a Springer Nature journal.

“Our work suggests there is a way to prevent SARS-COV-2 from injuring the body’s tissues and doing extensive damage,” said senior author of the study Zhe “Zion” Han, PhD, associate professor of medicine and director of the Center for Precision Disease Modeling at UMSOM. 

He notes that the most effective drug against Covid-19, remdesivir, only prevents the virus from making more copies of itself, but it does not protect already infected cells from damage caused by the viral proteins.Prior to the pandemic, Dr. Han had been using fruit flies as a model to study other viruses, such as HIV and Zika. He says his research group shifted gears in February 2020 to study SARS-COV-2 when it was clear that the pandemic was going to significantly impact the U.S.

SARS-COV-2 infects cells and hijacks them into making proteins from each of its 27 genes. Dr. Han’s team introduced each of these 27 SARS-CoV-2 genes in human cells and examined their toxicity. They also generated 12 fruit fly lines to express SARS-CoV-2 proteins likely to cause toxicity based on their structure and predicted function.

The researchers found that a viral protein, known as Orf6, was the most toxic killing about half of the human cells. Two other proteins (Nsp6 and Orf7a) also proved toxic, killing about 30-40% of the human cells. Fruit flies that made any one of these three toxic viral proteins in their bodies were less likely to survive to adulthood. Those fruit flies that did live had problems like fewer branches in their lungs or fewer energy-generating power factories in their muscle cells.

For the remaining experiments, the researchers focused on just the most toxic viral protein, so they could figure out what cell process the virus hijacks during infection. Dr. Han’s team found that the virus’ toxic Orf6 protein sticks to multiple human proteins that have the job of moving materials out of the cell’s nucleus—the place in the cell that holds the genome, or the instructions for life.

They then discovered that one of these human moving proteins, targeted by the virus, gets blocked by the cancer drug selinexor. The researchers tested selinexor on human cells and fruit flies making the toxic viral protein to see if the drug could help reverse the damage. Selinexor, like many cancer drugs is itself toxic. 

However, after accounting for its toxic effects, the drug improved human cell survival by about 12%. Selinexor prevented early death in about 15% of the flies making the toxic viral protein. The drug also restored branches in the lungs and the energy-generators in the muscle cells. Selinexor is FDA-approved to treat certain blood cancers.

More than 1,000 FDA-approved drugs are in clinical trials to test as treatments for Covid-19, and luckily a trial testing selinexor, the drug used in our study, is being performed already,” says Dr. Han. “If this trial proves to be successful, our data will have demonstrated the underlying mechanism for why the drug works.”

Executive Vice President for Medical Affairs at University of Maryland Baltimore, and  the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine, Albert Reece, MD, PhD, MBA, commented, “Although we now have vaccines, it may still be a while before we will have Covid-19 infections under control, especially with the new variants emerging. We will need to tap into every tool in the arsenal available to protect people from needless sickness, disability or even death, and this study guides us towards a new target for potential therapeutics.”

UM School of Medicine discovery opens the door to testing more effective drugs for treating  COVID-19 patients.


Cancer Drug Lessens Toxicity of Protein from Virus that Causes Covid-19

The United States continues to address and recover from the year-old COVID-19 pandemic, which has resulted in more than 500,000 deaths so far and a historic economic recession. Fifty top legal experts convene to offer a new assessment of the U.S. policy response to the crisis, 

COVID-19 Policy Playbook: Legal Recommendations for a Safer, More Equitable Future, 

and recommend policy solutions at all levels of government, as the nation works to quell the current crisis and carry out plans to rebuild.

According to a release, this report updates and expands the initial rapid COVID-19 legal assessment the experts published in August 2020. The assessment details how policymakers can best respond to and recover from the current pandemic, and reimagine the nation’s health care and public health systems to better prepare the nation for future infectious disease outbreaks.

In the report, the authors include proposals on how to strengthen executive leadership for a stronger emergency response, expand access to public health, health care and telehealth; fortify protections for workers; and implement a fair and humane immigration policy. Throughout, the authors explore what legal frameworks could help dismantle the structures of racism and inequality that produce unjust health outcomes now, and may prevent the nation from successfully navigating similar crises in the future.

Government efforts were inadequate to stop the United States from enduring the worst COVID-19 outbreak in the world, in large part because layered strategies were pursued ad hoc at the state and local levels without consistency or coordination, adequate guidance or evaluation, or necessary information. The response has largely been mounted in a contentious political atmosphere where the federal government consistently undermined public health efforts and messaging.

The Biden Administration has already taken promising early steps to implement a coordinated national strategy that will use existing federal powers to advance COVID-19 responses, harmonize guidance to encourage good public health practices, collect necessary data—including statistics on racial, ethnic, and economic disparities—to clearly assess the areas where targeted interventions are needed to slow COVID-19 transmission, and prioritize equity in policy making, including in vaccine distribution and the imposition of evidence-based community mitigation strategies and supports.

The division of power in the United States between the federal government and the states and tribal authorities, between branches of government within each jurisdiction, and between states and their local governments and tribal authorities is often a strength. During the COVID-19 pandemic, this dispersion of power helped ensure that some levels of government could respond to the pandemic even when others failed to do so. However, it also enabled political leaders to try to evade responsibility, and facilitated an inconsistent and often incoherent response.

Some recommendations in this policy report included:

State and local governments should continue to use targeted orders

 to implement social distancing and other community mitigation strategies to reduce transmission.

Centers for Disease Control and Prevention

should provide guidance to states, localities, and institutions

 about how to best target and layer these community mitigation strategies and standardize surveillance, contact tracing, and data management approaches.

Public health infrastructure must be repaired. 

The COVID-19 pandemic has demonstrated the importance of public health capacity, and Congress should fund efforts to expand the public health workforce, to modernize and expand public health institutions, and to support scientific research.

federal government should centralize, coordinate, standardize and regulate data collection and distribution 

related to public health responses, including the use of a consistent approach to contact tracing.

Federal, state, and local governments should enact policies that economically support individuals, businesses, and institutions during pandemics.

 Measures such as direct payments, childcare support, unemployment extensions, rental and food assistance, can help prevent disparate health outcomes. Legal protections from foreclosure, eviction, and utility shutoff moratoria, employment and anti-discrimination protections allow for better adherence with public health interventions and mitigation strategies.

Additional resources and attention must be given to

According to a joint statement by the report editorial committee:

“With the end of the pandemic in sight, it may be tempting to dismiss its continued danger, and our collective agency to address it. We cannot afford to do that. Instead, now is the time for policymakers to undertake the legislative and regulatory initiatives that are needed to ensure that the nation is better able to withstand the next pandemic, as well as the everyday health threats that made Americans more susceptible to the worst effects of this virus. This means we need to address the many ways in which our laws have perpetuated the longstanding inequities that left our population so uniquely exposed, and so unequally vulnerable, to COVID-19.

“It’s time for the nation to get out of the cycle of responding to public health emergencies with fleeting attention and urgency that wanes after case numbers subside. We need a sustained course correction that builds our resilience to handle current and future public health emergencies.

“We have a historic opportunity to take the lessons offered to us by the COVID-19 crisis, mount a recovery that protects and benefits everyone, and rebuild our public health system.Our approach must be rooted in advancing equity and it should be designed to create durable, meaningful change. In order to end this pandemic and better prepare for the next one, leaders need to ensure they are focused on building up the nation’s public health systems through law and policy based on evidence of what worked and what failed in the fight against COVID-19.”

COVID-19 Policy Playbook: Legal Recommendations for a Safer, More Equitable Future 

 JD, Professor and Director of the Center for Public Health Law Research at Temple University’s Beasley School of Law and College of Public Health.

Lance Gable, associate professor of law at Wayne State University Law School.

JD, National Director of the Network for Public Health Law.

Professor, Northeastern University School of Public Policy and Urban Affairs.

 Hall Render Professor of Law & Executive Director, Hall Center for Law and Health, Indiana University Robert H. McKinney School of Law

In this recent report, recommendations for ways to safeguard the U.S. from future pandemics are included.

50 Top Legal Experts Examine Inadequate Policy Response to COVID-19

 by Better Medicare Alliance, the leading research and advocacy group supporting Medicare Advantage, and conducted by 

, Medicare Advantage beneficiaries have reported

$1,640 less in total annual health spending

The analysis is based on 2018 Medicare Current Beneficiary Survey (MCBS) data, the most recent year available, and represents an increase in consumer savings from years past. ATI Advisory 

 of 2017 MCBS data showed a $1,598 lower health spending in Medicare Advantage while 2016 data 

40% lower rate of cost burden in Medicare Advantage

 than Traditional Medicare (11.8% versus 20%). The lower cost burden in Medicare Advantage is of added importance given that 52.7% of Medicare Advantage beneficiaries live below 200% of the Federal Poverty Level, compared to 39.1% of Traditional Medicare beneficiaries. Cost burden is defined as spending 20% or more of one’s income on health costs.


“Congress and the Biden administration have set a worthy goal of lowering consumer healthcare costs and securing the best value possible for the Medicare dollar. This analysis shows that Medicare Advantage continues to do exactly that,”

said Allyson Y. Schwartz, president and CEO of the Better Medicare Alliance

“With strong consumer protections, including an annual cap on out-of-pocket expenses, Medicare Advantage is saving beneficiaries an average of $1,640 a year over Traditional Medicare. This results in 40% lower cost burden for consumers than Traditional Medicare. The consumer savings in Medicare Advantage translates to meaningful financial security and peace of mind for millions of beneficiaries.”

 successes like these don’t happen by accident. 

"Medicare Advantage depends on support from policymakers to deliver consumer savings, 

 for its proportionally lower-income beneficiary population, many of whom have complex chronic conditions," she said. "With this research in hand, we look forward to working with Congress and the Administration to maintain and strengthen this coverage lifeline for the 26 million Americans who rely on Medicare Advantage for their health care needs.”

Allison Rizer, principal at ATI Advisory and study lead, said 

Medicare Advantage is continuing to prove its value

“We’re seeing plans increasingly shifting toward person-centered care, with innovative supplemental benefits and clinical models," Rizer said. "This latest analysis shows th

at Medicare beneficiaries also rely on Medicare Advantage for financial protection against high out-of-pocket and premium costs.”

Analysis also shows higher proportion of low- and modest-income beneficiaries in Medicare Advantage than Traditional Medicare.

MHE Staff

Articles

Nursing Homes See 96% Decline In COVID Cases Since Vaccine Rollout

Cancer Drug Lessens Toxicity of Protein from Virus that Causes Covid-19

50 Top Legal Experts Examine Inadequate Policy Response to COVID-19

Medicare Advantage Saves Beneficiaries $1,640 a Year, Delivering 40% Lower Cost Burden than Traditional Medicare