Ranking Member Ruiz’s Opening Statement at Select Subcommittee Hearing Examining Pandemic Nursing Home Policies

Washington, D.C. (May 17, 2023)—Below is Ranking Member Raul Ruiz's, M.D. opening statement, as prepared for delivery, at today's Select Subcommittee on the Coronavirus Pandemic hearing examining nursing home mortality and COVID-19 policies.

Opening Statement

Ranking Member Raul Ruiz, M.D.

Select Subcommittee on the Coronavirus Pandemic

Hearing on "Like Fire Through Dry Grass: Nursing Home Mortality

and COVID-19 Policies"

May 17, 2023

Thank you, Mr. Chairman.

First, let me begin by thanking you, Ms. Dean and Ms. Zayas, for being here today.

I am deeply sorry for your losses.

Any death due to COVID-19 is a tragedy, and my heart is with you and the families of the 200,000 residents and staff of long-term care facilities across the country who perished during the pandemic.

Three years ago, a novel, deadly highly transmissible airborne virus took hold.

And while we knew little about COVID-19 and its long-term impacts on human health at the time, we did know that our nation's seniors were among our most vulnerable when it comes to suffering severe illness and death.

So as COVID-19 swept the country and the federal response to this virus faltered under President Trump states were forced to grapple with an unfamiliar public health threat, and yes, policy missteps were made.

On March 4, 2020, the Centers for Medicare and Medicaid Services issued guidance permitting nursing homes to admit and readmit COVID-19-positive patients, but only if the nursing home could do so safely, following protocols to prevent transmission among residents and staff.

However, in an attempt to relieve hospital strain in a time of crisis, states like New York went beyond this guidance, requiring nursing homes to reopen their doors to COVID-positive patients.

Now, as COVID-19 hospitalizations and deaths have decreased exponentially thanks to the availability of vaccines and improved therapeutics, we must build better policies that will save lives and prevent future harm in the event of another pandemic.

As members of this Select Subcommittee, we must develop forward-looking policies that promote transparency and strengthen protections in nursing homes to mitigate current and future threats.

We must also look to rehabilitate nursing home systems weakened by the previous Administration's efforts to roll back regulations that established guardrails for quality of care and staffing levels—leaving those facilities under-resourced and underprepared to combat a deadly virus.

For example, in July 2019, seven months before the pandemic took hold, the Trump Administration's proposed deregulation of on-site infection control resulted in facilities cutting corners, assigning already overworked nurses to take on responsibilities intended for infection-control specialists. At the same time, the previous administration proposed loosening standards to review patient care needs, reduced consequences for nursing home regulation violators, and lifted protections for residents and families to take legal action in the event of mistreatment.

What's more, the Trump Administration's prolonged failure to secure adequate PPE and testing kits led to increased transmission in both nursing homes and their surrounding communities.

For example, a 2021 NIH study found that nursing homes in the same communities that experienced high rates of infection saw extreme shortages in rapid COVID-19 testing.

The deregulation of the nursing home industry coupled with shortages in COVID-19 tests and PPE were also missteps and contributed to devastatingly high rates of nursing home deaths—as high as nearly one out of every 50 residents at the peak of the pandemic, according to AARP.

So, when the next pandemic rolls around, we must ensure that our nation's nursing homes and long-term care facilities are fully equipped to respond to and reduce transmission of a deadly novel virus.

This means identifying real solutions now that will prevent harm and save lives in the future.

We cannot allow overwhelmed health care staff to be left behind, and we must adequately equip them with the resources they need to provide quality care and services to their patients.

Under President Biden's leadership, we have taken meaningful steps toward this goal.

This includes reinstating enforcement of federal nursing home standards, improving inspection, and strengthening our health care workforce.

And let's not forget successfully and efficiently delivering lifesaving vaccines to our most vulnerable populations, significantly reducing the death rate among nursing home residents.

Now, there is more work to do.

Let's make sure we're sufficiently investing in skilled nursing home staff and infection control measures.

And let's hold to account those bad actors in the nursing home industry who skirted regulations and fueled the alarming death toll we experienced during the height of the pandemic.

We can all agree that we can and must do better. I am confident that if we work together, we can identify common-sense bipartisan solutions that put people over politics, save lives, and right the wrongs that caused so much suffering in this pandemic.

Thank you. ###