The following paragraph is not from the Onion, but from the New York Times.
The Trump administration has been working to relax regulations governing America’s nursing homes, including rules meant to curb deadly infections among elderly residents.
In yet another mindless effort in “deregulation,” the Center for Medicare and Medicaid Services (CMS), headed by Trump appointee Seema Verma, has set its sights on changing a federal rule imposed during the Obama administration which requires that nursing homes employ at least one specialist in preventing the spread of infections. The rule change, set in motion last summer, “followed a spate of lobbying and campaign contributions by people in the nursing-home industry,” according to the Times’ investigation. That industry has benefited heavily from the Trump administration’s “deregulatory” zeal, and is touted by CMS’ own estimates to save $640 million in yearly costs by the repeal of “pesky regulations” such as this.
The current rule requires such specialists be employed at least part-time by the facilities. The Trump rule, proposed in July, 2019 and now working its way through the regulatory process, would simply require that such a specialist spend “sufficient” time at the facility, which could translate to one day a month—or perhaps only a few days a year. Advocates for nursing home reform say that the wording is so vague it would impose an “essentially meaningless” requirement on any facility, and 17 attorneys general from across the country have called the rule change a “threat” to the safety of nursing home residents.
Like many of the Trump’s efforts to “deregulate” to satisfy the endless wish lists of its political contributors, this particular rule change has largely flown under the radar. Its sheer folly is now being thrown into sharp relief, with the looming coronavirus pandemic. Thirteen residents of the LifeCare Center nursing home in Kirkland, Wash. died after exposure to the coronavirus, an exposure that is attributed to poor hygiene practices at that facility. One-third of its workers have also been infected. And less than a year ago, that very same facility was reprimanded and fined for its failure to “consistently implement an effective infection control program.”
Infectious disease specialists play a vital role in preventing infections at such homes by, among other things, ensuring staff follow approprate infection safety protocols. Of course, the elderly population that make up the vast majority of the 2.5 million nursing home residents in this country are also the most vulnerable to the COVID-19 coronavirus. They are not only more susceptible to contracting the virus, they are the most likely to have preexisting conditions and weakened immune systems that allow the virus to thrive. The elderly have the highest death rates associated with COVID-19, by far, as the Times notes.
Infection-prevention specialists are supposed to ensure that employees at nursing homes properly wash their hands and follow other safety protocols. They are widely considered the front line for stopping infections, among the leading causes of deaths in nursing homes.
Each year, about 380,000 residents are killed by infections, according to the Medicare agency. Failure to prevent them is also the leading cause of citations that state inspectors bring against nursing homes.
The essence of this is that the nursing home industry didn’t want to have to pay for an infectious disease specialist on staff in each of its facilities; that would cut into their profits. The Times notes that, like all of Trump’s efforts to loot our federal agencies for private interests, this particular rule change can be traced back to cronyism.
The administration’s moves came after intense lobbying by the nursing home industry, including by the firm run by Brian Ballard, Mr. Trump’s friend and a fund-raiser. Parlaying his personal connections to Mr. Trump, Mr. Ballard has become one of the most powerful lobbyists in Washington, with the most clients of any registered lobbyist last year, according to an analysis by the Center for Responsive Politics. His firm has lobbied on behalf of nursing homes in his home state, Florida, for years, according to public records. (He was also a lobbyist for Mr. Trump’s Florida golf course, the Doral.)
The consequences of these seemingly minor rule changes, usually drafted and published in the oblique pages of the Federal Register where they are only read and noticed by industry insiders, can be absolutely devastating. The problem is that those consequences are usually only made apparent in hindsight, after the rules have already been changed. But this is one of those rare instances where we can see the likely consequences of such “deregulation” happening in real time.