Pennsylvania Health Secretary Rachel Levine (a biological male born Richard Levine but identifying as transgender), President Joe Biden’s pick for assistant secretary of health at the Department of Health and Human Services (HHS), refused to answer an important question about his record on forcing nursing homes to admit COVID-19-positive patients.
Sen. Richard Burr (R-N.C.) laid out the scandal in his opening remarks at Levine’s confirmation hearing on Thursday.
“Along with testing challenges from last spring, your state failed to adequately protect nursing home residents from the virus and is making unacceptable mistakes in the vaccine distribution process,” Burr noted.
“Pennsylvania ranks as one of the most dangerous states for long-term care residents battling COVID-19. Fifty-two percent of Pennsylvania COVID-19 deaths came from nursing homes, and three in ten of the deadliest facilities in the country were in Pennsylvania. Your state came in 46th in the country in its effort to put safeguards in place that managed the spread of infections in these settings with only 16 percent of the state’s nursing homes receiving infection control inspections that could have saved residents from the spread of COVID-19,” Burr claimed.
Indeed, 52 percent of COVID-19 deaths in Pennsylvania have occurred in nursing homes and other long-term care facilities. As for the 46th in the country rating, that appears to trace back to Families for Better Care, which ranked Pennsylvania near last for dangerous conditions in nursing homes when it released its 2019 Nursing Home Report Card.
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“While you stated that you relied on federal guidance for nursing home care during the pandemic, the tragic high mortality rate in your state’s nursing homes shows that more was needed [from you] but wasn’t provided,” Burr went on. “In my state of North Carolina, our health secretary also relied on federal guidance for nursing homes and long-term care settings. In North Carolina, our nursing home mortality rate, while still high, accounts for 36 percent of the deaths in our state. This discrepancy clearly shows that hiding behind federal guidance is no excuse for [not] taking action that protects our most vulnerable.”
“I look forward to understanding exactly why your decisions, when relying on the same federal guidelines as my state, resulted in a different outcome for Pennsylvania’s seniors,” Burr said.
Burr gave Levine an opportunity to explain himself, but the secretary dodged the question.
“As I mentioned in my opening statement, your state continues to struggle with COVID-19 response. How can you ensure that the same challenges that Pennsylvania experienced in testing, nursing home care, and now vaccinations, will not occur when given the opportunity to serve in the public health policy area?” Burr asked.
Levine thanked Burr for the “opportunity to respond” to the question, but he did not offer a response on the vital issue of nursing homes. Instead, he said his state faced “challenges.”
“Well, senator, thank you for that question and the opportunity to respond. In Pennsylvania, we did work to have a science-based response to COVID-19,” Levine said. “There were significant challenges. This is a novel coronavirus, and especially in the spring, we had challenges with testing, we had challenges with contact tracing, et cetera. We had a lack of personal protective equipment, as most other states did.”
“I think that the nation’s response has improved significantly. And under President Biden’s leadership… if confirmed, I look forward to my role in the nation’s response,” Levine added.
In other words, Levine said nothing about the nursing home scandal, and it appears the issue did not come up again in the hearing. That is a crying shame.
In May, multiple members of the Pennsylvania State House demanded Levine’s resignation over “the horrific results of the [health] department’s COVID-19 policy” on nursing homes and other facilities under the department’s oversight. More than half (10,022) of Pennsylvania’s 19,390 COVID-19 deaths can be traced back to long-term care facilities. In May, long-term care facilities made up two-thirds of the state’s COVID-19 deaths and Levine reportedly delayed releasing public information about the state’s response to the virus in such facilities.
In March, the Pennsylvania Department of Health under Levine had released guidelines for nursing facilities, saying they “must continue to accept new admissions and receive readmissions for current residents who have been discharged from the hospital who are stable to alleviate the increasing burden in the acute care settings. This may include stable patients who have had the COVID-19 virus.”
This order contradicted guidance from the Centers for Medicare and Medicaid Services (CMS) on March 13. “This guidance does not direct any nursing home to accept a COVID-19 positive patient, if they are unable to do so safely,” the federal agency wrote. Instead, CMS advised that “nursing homes should admit any individual that they would normally admit to their facility, including individuals from hospitals where a case of COVID-19 was/is present” only if the nursing home can follow” CDC guidance.
CMS Administrator Seema Verma also warned, “Under no circumstances should a hospital discharge a patient to a nursing home that is not prepared to take care of those patients’ needs.”
Yet the scandal is also personal.
In May, Levine removed his mother from a personal care home as COVID-19 spread in such elderly facilities. Levine insisted that his mother was in a personal care home, not a nursing home, but COVID-19 has spread in personal care homes similar to the way it spread in nursing homes.
“My mother requested and my sister and I as her children comply to move her to another location during the COVID-19 outbreak,” Levine said at a press conference in May. “My mother is 95 years old. She is very intelligent and more than competent to make her own decisions.”
Levine’s mother may indeed be able to make her own decisions, but this removal still seems suspicious. Did Levine move to protect her mother from the virus even while ordering facilities for the elderly to admit COVID-positive patients?
While I applaud Sen. Rand Paul’s (R-Ky.) decision to press Levine on his support for the chemical castration of children, I also think more senators should have spent time asking Levine about nursing homes.
Tyler O’Neil is the author of Making Hate Pay: The Corruption of the Southern Poverty Law Center. Follow him on Twitter at @Tyler2ONeil.