Long-Term Care Ombudsman Advocates for Nursing Home Residents

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Heritage Hall in Nassawadox on Thursday, April 30, 2020. Photo by Connie Morrison.

By Carol Vaughn —

Family and friends of nursing home residents on the Eastern Shore have not been able to visit them in person since March, when facilities imposed restrictions because of the COVID-19 pandemic.
Still, anyone with concerns about a nursing home resident on the Eastern Shore — whether it’s about COVID-19 or some other issue — has an advocate to turn to, Ombudsman Beth McGlothin.
“The job of the ombudsman is to receive and investigate concerns, complaints from residents and/or families about the quality of care,” she said.
McGlothlin, a nurse by training, for the past 14 years has worked for the Virginia Long-Term Care Ombudsman Program, a state program under the Department of Aging and Rehabilitative Services.
The program, authorized under the federal Older Americans Act, is charged with helping resolve problems, protecting individuals’ rights, and promoting quality in nursing homes, assisted living facilities, and home and community settings.
That includes group homes and people receiving home health services.
The service is at no cost to residents and their families — ombudsmen are paid by a combination of state, federal, and local funds. It is also confidential.
It gives families and residents someone to turn to outside the facilities’ own staff.
Call McGlothlin at 757-710-3397 for ombudsman services on the Eastern Shore.
For information about the state program, go to www.ElderRightsVa.org.
McGlothlin, like others, has not been able to enter the facilities because of the pandemic and is doing her work mainly by telephone for now.
Her office is at the Eastern Shore Area Agency on Aging/Community Action Agency building at 5432 Bayside Road in Exmore, although it is not open to the public at present.
In normal times, nursing home residents become accustomed to seeing her regularly and know she is someone they can talk to.
“Sometimes you just need somebody to talk to, and a lot of times with families I find that there is frequently missed communication,” she said.
“A lot of times, from my perspective, when a family or a resident contacts me there is frequently, as I dig through it and investigate it — which means that I start checking into what has been going on, what is the true plan for this person, medically speaking how is that supposed to be — a lot of times there is misunderstood communication from family or resident to staff or vice versus. And sometimes it can get heated…It’s a complex system,” McGlothlin said.
The situation is harder still now that the coronavirus pandemic has affected thousands of long-term care facility residents and staff around the nation, making them among the hardest hit groups.
Accurate data is hard to come by, in part because of healthcare privacy regulations.
More than 43,000 long-term care residents and staff have died from COVID-19 — that’s over a third of the United States’ known coronavirus deaths, according to the Kaiser Family Foundation.
The number likely is an undercount, according to a recent AARP article, which noted that, although states are required to report confirmed COVID-19 cases and deaths in nursing homes to the Centers for Disease Control and Prevention and individual facilities are required to report the information to residents and their families, they are not required to make the information public — and not all do.
Here is what is known:
In Virginia, 5,600 cases and 898 deaths have been reported in long-term care facility outbreaks.
The Eastern Shore has had 832 cases, and 73 among healthcare workers, associated with outbreaks, including in four long-term care facilities and six congregate settings.
The Virginia Health Department does not give more specific information at the health district level, such as how many hospitalizations and deaths are associated with outbreaks.
A health department official told county officials in May around 94 of 220 people the National Guard tested at Heritage Hall in late April tested positive for the virus.
A spokesperson for the facility said in a May 5 email the test results included 46 employees and 43 residents who tested positive.
Shore Health and Rehab Center in Parksley reported the week of May 31 it had one confirmed COVID-19 case; four total suspected cases; no COVID-19 deaths; and 102 out of 136 available beds occupied, according to a new federal database.
Additionally, the facility reported nine confirmed COVID-19 cases and six suspected cases among staff as of May 31.
Rep. Elaine Luria is among a group of members of Congress who expressed concerns about the federal response to the pandemic in nursing homes in a June 5 letter to Alex Azar, Secretary of the Department of Health and Human Services, and Seema Verma, Administrator of the Centers for Medicare and Medicaid Services.
More than 40% of COVID-19 deaths in the nation have been among residents and workers in long-term care facilities, according to the letter.
“While the persistent shortage of testing kits and delayed reporting and disclosure of COVID-19 outbreaks in nursing homes continue to obscure the full magnitude of this crisis, recent tragedies have made it painfully clear that our nursing homes are in dire need of additional federal support and guidance,” it says, in part.
The signers wrote they are pleased the CMS heeded calls from Congress and the public for stronger COVID-19 reporting requirements for nursing homes, but are concerned steps are not being taken to collect data on cases and deaths prior to May 1 and that demographic data is not being collected.
“All nursing home residents, workers, and families affected by the COVID-19 pandemic deserve to be counted,” the letter says.
The signers asked for answers from Verma and Azar by June 26 to a series of questions, including what efforts their departments are taking to increase testing in nursing homes; how they will ensure states and nursing homes have adequate funding to care for COVID-19 patients; what personal protective equipment will be sent to nursing homes; whether they will publicly report demographic data for nusing home cases; and whether the Department of Health and Human Services plans to make additional payments to nursing homes and other providers that rely heavily on Medicaid, among other questions.
HHS on May 22 announced $4.9 billion in funding for skilled nursing facilites certified by Medicare as part of federal response to the pandemic.
“While many communities are in dire need, our nation’s most vulnerable individuals cannot be overlooked in our efforts to defeat COVID-19,” the letter concludes.
For McGlothlin, the work continues here during the pandemic and beyond, seeking to help individual residents and their families cope.
“Sometimes having me involved means that the resident can say what’s really on their mind without feeling like they are going to offend the staff — and then we can figure out how we go about changing what’s happening,” she said, adding, “My goal is to resolve the issue to the satisfaction of the person living in the nursing home and/or to the satisfaction of the family…Most of the times issues that come up can be worked out.”