Oregon state agencies failed to act as COVID hit long-term care facilities: Report

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Oregon public agencies were not equipped to respond to a pandemic that overwhelmed the state’s understaffed long-term care facilities, state officials report.

The report, released on Wednesday, concerned the 685 long-term care facilities around the state and was conducted by the Oregon secretary of state’s audit division. It is not considered an audit under government auditing standards, its authors noted, despite going through the same quality assurance process.

According to the report, poor planning and disagreement on the part of the Oregon Health Authority and the Oregon Department of Human Services early in the pandemic put some 31,581 adult care facility patients at risk.

The two agencies wasted “valuable time” in the first few months after Oregon’s first case as they tried to figure out how to work together, state officials wrote.

“Delayed actions around outbreaks in long-term care facilities was due, in part, to a lack of prior planning for a joint ODHS/OHA response, and state regulations for emergency preparedness in community-based care facilities are lacking compared to federal regulations for nursing facilities,” the report said. “More rigorous regulations and interagency assistance at the state and local level will better prepare long-term care facilities for natural disasters, communicable disease outbreaks, and other emergencies.”

State officials wrote further that the agencies did not even boast a basic plan for communicating with one another. Such plans were “developed after the response began, delaying actions that may have prevented illness and death among long-term care residents and staff.”

State researchers concluded that the state’s long-term care facilities share the blame. Its authors reference federal findings from September which identified the rest home industry as part of “an already precarious care system” which was “hampered by too few staff, who are paid too little for physically and emotionally taxing work.”

Their report further found that last November, just 10 Oregon rest homes had trained half or more of its staff members in state-provided infection control.

Oregon has maintained a large number of adult long-term care homes through such measures as raising reimbursement rates for serving Medicaid beneficiaries. The state’s long-term care costs can add up to thousands more than the national average. In 2020, a semi-private room in Oregon cost more than $28,000 than the average price tag nationwide.

Still, Oregon’s long-term care facilities have fared better than most in the nation. The report cites data from the Centers for Medicare and Medicaid which show the state’s long-term care facilities experienced relatively low COVID-19 case and mortality rates compared to its neighbors. Last Halloween, Oregon ranked 40th in cases and 43rd in deaths in long-term care facilities per 100,000 residents.

To date, there have been 13,588 COVID cases and 1,265 deaths from the virus in congregate care settings, according to the Oregon Health Authority‘s most recent reports. Such deaths account for more than half of the state’s death toll to date from the pandemic.

The report’s recommendations include tracking vaccination rates among rest home staff and making them public. The state’s long-term care ombudsman, researchers wrote, should play a larger role in reviewing such facilities.

According to the report, rest homes would also be better served with at least seven COVID-19 new recovery units, monthly COVID testing, and more frequent onsite inspections.

Several bills in the state legislature this session seek to improve the state’s emergency preparedness as a whole, including its wildfire responsiveness.

The state’s vaccine rollout for seniors continues to be the source of controversy in and out of the state legislature where GOP lawmakers walked out in protest of what they regarded as a lax effort to vaccinate seniors earlier his month. According to data from the OHA, less than one out of two Oregon seniors ages 65 and up have received at least one shot of a COVID-19 vaccine.

Oregon as a whole is part of a much brighter picture. On Wednesday, the OHA announced that one million Oregonians have been vaccinated with one or more doses of a COVID-19 vaccine. The state is further committed to the federal deadline for offering priority vaccinations for everyone 16 and older by May 1.

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