Senate Special Committee discusses COVID-19 impacts on California skilled nursing facilities

The Senate Special Committee on Pandemic Emergency Response held a meeting on Wednesday to discuss the ways COVID-19 is impacting residents and workers at California’s skilled nursing facilities (SNFs), and to examine recommendations for the best path forward.



At the start of the meeting, Committee Chair Sen. Lena Gonzalez noted that prior to the pandemic, many nursing homes in California were not providing adequate care to residents. She described a 2018 State Auditor’s report which found that citations for substandard care at skilled nursing facilities increased 31% between 2006 and 2015.

“We entered the COVID-19 pandemic with a nursing home system in need of many improvements in a number of areas,” said Gonzalez.

According to the most recent data from the California Dept. of Public Health, there have been 11,249 positive COVID cases among SNF residents and 6,796 cases among SNF healthcare workers in the state. The data shows that over 40% of the COVID-19 deaths in California are associated with skilled nursing facilities.

“COVID-19 is like nothing we’ve ever seen in terms of pandemics in this setting before. It has been particularly difficult for the most vulnerable populations in our society which are elderly and people who are health compromised — and that is 100% of the people who are residents and patients in skilled nursing facilities,” testified Craig Cornett, President & CEO of the California Association of Health Facilities.

During the informational hearing, Dr. Jeffrey Gunzenhauser, Chief Medical Officer for LA County’s Dept. of Public Health, spoke to the committee about the outlook in LA County, where he says that of the 315 freestanding SNFs in their jurisdiction, over 250 have experienced at least one case of COVID-19. As of June 9, about 25% of LA’s COVID cases have occurred in institutions including SNFs, and 51% of the county’s deaths have occurred among SNF residents.

Gunzenhauser provided the committee with an overview of how LA County is working to limit the virus’s spread and said that looking to the future he wants to see support for local health departments to address infection control issues, support for information systems to track health outcomes and services, and support for systems to protect health care workers.

Gunzenhauser also told the committee LA County recently adopted a motion to appoint an inspector general to report on operations and oversight of SNFs in the county.

Santa Clara County Health Officer Dr. Sarah Cody also offered testimony, describing some of the workforce challenges seen in SNFs. Two of Santa Clara’s facilities had large outbreaks, says Dr. Cody, resulting in staffing shortages due to fear and illness. She also says the county has had to deal with rapid turnover in the workforce.

“Another underlying issue that we have found is that many of our workers in skilled nursing facilities come from the same communities in our county that are disproportionately impacted by COVID. And so, the skilled nursing facilities in many ways represent the inequities in the way that COVID is impacting our population in general,” said Cody,

Many of those who testified at the hearing also stressed the importance of securing adequate personal protective equipment and ensuring the continued availability of testing supplies.

Tony Chicotel, staff attorney for the California Association for Nursing Home Reform (CANHR), was the final panelist to offer testimony during the meeting. He brought the conversation back to the poor past performance of SNFs in the state.

“Much of the devastation in nursing homes has been avoidable. We have had decades of feeble state leadership and half-hearted enforcement from DPH… we have created the environment in which pandemics will kill nursing home residents with horrific success,” said Chicotel.

Chicotel outlined CANHR’s 10 point plan for statewide long-term care reform which focuses on enforcement and accountability, raising staffing minimums, and emergency preparedness.

“This pandemic has not broken the system; it has revealed it. The system does not prioritize resident experience. Residents are bystanders and too often victims. This needs to change,” said Chicotel.

The full meeting is available here.