Jul 01, 2020
Dems: Nursing home virus effort chronicle of deadly delay
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WASHINGTON (AP) — The Trump administration was slow to comprehend the scale of COVID-19’s impact on nursing homes and a disjointed federal response has only compounded the devastating toll, according to a report from Senate Democrats.
The report due out Wednesday, a copy of which was provided to The Associated Press, finds a lack of coordination among government agencies hindered access to coronavirus testing and protective equipment, among other problems.
“Unfortunately for the nation, it is a chronicle of deadly delay, and a lack of urgency, and the lack of a strategy,” said Sen. Bob Casey of Pennsylvania, ranking Democrat on the Aging Committee. “What we see in the way the administration handled this reflects the administration’s failure in responding to the pandemic generally.”
Sens. Ron Wyden, D-Ore., and Gary Peters, D-Mich., joined in the report.
The head of the Centers for Medicare and Medicaid Services, the lead federal agency on nursing homes, defended the administration’s record. “The report is disingenuous,” said Seema Verma. “I think the agency has had a historic and unprecedented response and should be commended for its efforts.” Verma cited numerous agency alerts and guidance documents directed to nursing homes. CMS also says it has redoubled emphasis on inspections for infection control.
Investigative agencies like the Government Accountability Office and the Health and Human Services inspector general are also focusing on nursing homes, which house a tiny share of the population but represent a large proportion of COVID deaths. The issue could have political repercussions for President Donald Trump as he tries to persuade older Americans to back him for a second term.
Even now, four months after the first nursing home outbreak was reported in Kirkland, Washington, on Feb. 29, there’s no consensus estimate of the extent of suffering and death.
Statistics reported by nursing homes to the federal government as of June 14 show nearly 30,800 residents have died, according to an AP analysis.
Several news organizations have reported higher numbers. An AP count that includes nursing homes and other long-term care facilities finds nearly 52,500 deaths, combining residents and staff. Either way, that’s a disproportionate share of the total 127,000 deaths nationwide.
The report, prepared by Democratic Senate staff, found that:
— It took the administration several months — until early May — to require that nursing homes report data on coronavirus cases and deaths to the Centers for Disease Control and Prevention and CMS. The data remains incomplete, the report says, because it lacks demographic details and may not include cases early in the pandemic. Verma said such data collection efforts can take years to set up, and that CMS may well ask for demographic details.
— Urgent recommendations from the White House and guidance from CMS to test nursing home residents and staff did not translate to results on the ground because there was no system in place to guarantee the availability of tests and supplies. Verma said CMS tried to help by changing its rules to allow labs to go into nursing homes and collect samples.
— A FEMA initiative launched at the end of April to distribute supplies to nursing homes involved unnecessary delays, delivered faulty and unusable personal protective equipment to some locations, and initially left other facilities off the distribution list though they appeared to be eligible.
— Although Congress allocated $175 billion in emergency funding for health care facilities and service providers, nursing homes appear to have gotten a relatively small share, delivered in recent weeks. An initial $4.9 billion was provided in late May, and more money was sent out this month, in a distribution geared to facilities serving Medicaid patients.
The report largely avoids criticism of the nursing home industry, which has been cited for poor infection control practices and chronic staffing shortages. Staff members often work at multiple facilities and may have unwittingly contributed to spreading the virus, since people can be contagious without any noticeable symptoms. Once inside a nursing home, the coronavirus encounters an ideal environment in which to spread.
Defending the administration, Republican lawmakers suggest at least part of the blame lies with several Democratic governors who required nursing homes in their states to accept recovering coronavirus patients.
CMS has impaneled a 25-member commission to analyze what happened in nursing homes and make recommendations to better protect elderly and frail residents.
The report from Senate Democrats also includes some recommendations, among them promoting strategies that have worked to allow nursing homes to safely care for coronavirus patients, accelerating the ongoing shift to home- and community-based care, and raising the pay and status of nursing home staff.
“I’m not saying that government can wave a magic wand and eliminate the threat, because the context of a nursing home is challenging,” Casey said. But “there’s no excuse for having this many deaths under any circumstances.”
Associated Press data editor Meghan Hoyer and investigative researcher Randy Herschaft contributed to this report.
Copyright © 2020 The Associated Press. All rights reserved. This material may not be published, broadcast, written or redistributed.
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Delay and Disruption: Fired Prosecutor Has Serious Concerns About Bill Barrs Motives
US Attorney General William Barr on July 13.Oliver Contreras/Sipa via AP ImagesFor indispensable reporting on the coronavirus crisis and more, subscribe to Mother Jones' newsletters.
Geoffrey Berman, the recently ousted US attorney for the Southern District of New York, last Thursday told the House Judiciary Committee, around 25 times, that he feared Attorney General William Barr’s efforts to replace him with someone from outside that office would have caused the “delay and disruption” of active investigations.
Berman’s former office is reportedly investigating Trump’s lawyer, Rudy Giuliani, in relation to a scheme to help Trump by digging up dirt on Joe Biden in Ukraine. The office has looked into the finances of Trump’s 2016 inaugural committee. It is prosecuting Halkbank, a Turkish state-run bank, for violating US sanctions on Iran—a probe that former national security adviser John Bolton alleges Trump promised to curtail as a favor to Turkey’s president. And Manhattan prosecutors have probed the Trump Organization and hush money payments related to Trump’s 2016 campaign.
“I believe the attorney general was trying to entice me to resign so that an outsider could be put into the acting US attorney position at the Southern District of New York, which would have resulted in the delay and disruption of ongoing investigations,” Berman said, one of various iterations of this assertion. Berman also threw in the word “impede” half a dozen times.
Berman, under the terms he negotiated with the Justice Department, declined to be more specific. During the three-hour, 41 minute interview, he said, around 15 times, that he didn’t know what Barr’s “motives” were. But he described Barr’s actions, eight times, as “irregular and unexplained.” Even so, the interview—the transcript of which was released to the public Monday evening—has received only modest attention.
In more normal times, like February, it would probably have been a bigger deal that the just-fired head of one of the most powerful prosecutor’s offices in the country seemed to suggest, over and over again, that the attorney general’s scheme might have derailed investigations of personal interest to the president.
Quick rehash: On June 19, Barr pressed Berman to accept a nomination for a different job in the Trump administration and proposed replacing him with an official from outside the office. Barr’s plan was to have Trump nominate Jay Clayton, the head of the Securities and Exchange Commission, for Berman’s job. Barr also wanted Craig Carpenito, the United States attorney for New Jersey, to serve simultaneously as acting head of the Manhattan office while Clayton awaited Senate confirmation. (“The U.S. attorney for the Southern District of New York is not a part-time position,” Berman remarked in his congressional testimony.)
Berman refused to resign, but Barr nevertheless issued a press release that falsely said Berman had agreed to step down. (This was one of a series of highly controversial moves the Trump administration has recently announced on Friday nights. Last Friday, Trump commuted the three-year prison sentence that his longtime adviser Roger Stone received for lying to Congress and witness tampering). Berman responded to Barr with his own defiant release, refuting Barr’s claim that he was resigning and arguing, based on the unusual circumstances of his appointment, that Barr lacked the power to oust him. The next day, Barr announced Trump had fired Berman, a claim Trump promptly undermined by denying any involvement. Still, Berman then agreed to step down. He says that is because Barr quietly agreed to make Berman’s deputy, Audrey Strauss—rather than Carpenito—the acting head of the office. “With that concession, and having full confidence that Audrey would continue the important work of the office, I decided to step down and not litigate my removal,” Berman said Thursday.
Stephen Castor, the GOP congressional lawyer who drew attention for his stumbles during last fall’s impeachment hearings, returned to form Thursday when he asked Berman: “There was no quid pro quo proposed, correct?” Berman: “You know, he wanted me to resign to take a position. I assume you could call that a quid pro quo. You resign and you get this, that would mean quid pro quo.”
Absent from Thursday’s interviews was discussion of which specific investigations Berman was worried about being delayed, disrupted, or impeded—and what if any impact they might have on Trump’s chances in November. Berman declined, 35 times, to answer questions related to investigations.
But Democratic aides pointed out Thursday that prosecutors in Manhattan are reportedly investigating Giuliani, Trump’s personal lawyer, for activity connected to the scheme that led to Trump’s impeachment. Reuters reported last year that a New York grand jury subpoenaed records of payments to Giuliani. And the New York Times said prosecutors were looking into whether Giuliani broke foreign lobbying laws by allegedly helping a Ukrainian official influence US policy toward Ukraine. Giuliani disputes doing this and has questioned whether he is really under investigation.
Wherever that alleged investigation stands, a “delay and disruption” of it would presumably benefit Trump.
Berman’s former office in 2018 also essentially called Trump an unindicted conspirator (“Individual-1”) in a campaign fraud scheme in which his former personal lawyer, Michael Cohen, paid women who said they’d had affairs with Trump to stay silent ahead of the 2016 election. The Justice Department has a policy that bars prosecuting a sitting president. If Trump loses, prosecutors at least in theory could charge Trump in January.
“Do you know one way or another whether Attorney General Barr removed you so that you would not be making the decision whether to investigate the president prior to the 2020 elections or whether to indict him after the 2020 elections?” a Democratic aide asked Berman.
“I do not know what the attorney general’s motives were,” replied Berman, “but the irregular and unexplained actions by the attorney general raised serious concerns for me.”