Nursing Homes Fought Federal Emergency Plan Requirements for Years. Now, They’re Coronavirus Hot Spots.

On Dec. 15, 2016, the nation’s largest nursing home lobby wrote a letter to Donald Trump, congratulating the president-elect and urging him to roll back new regulations on the long-term care industry.

One item on the wish list was a recently issued emergency preparedness rule. It required nursing homes to draw up plans for hazards such as an outbreak of a new infectious disease.

Trump’s election, the American Health Care Association, or AHCA, wrote, had demonstrated that voters opposed “extremely burdensome” rules that endangered the industry’s thin profit margins.

“Part of the public’s message was asking for less Washington influence, less regulation, and more empowerment to the free market that has made our country the greatest in the world,” AHCA wrote. “We embrace that message and look forward to working with you to improve the lives of the residents in our facilities.”

The letter was another salvo in the industry’s fight against regulations designed to stop diseases like COVID-19 from devastating elderly residents of the nation’s nursing homes, according to a review of documents and data by New Mexico In Depth; The News & Observer of Raleigh, North Carolina; and ProPublica.

The lack of pandemic plans helps explain why nursing homes have been caught unprepared for the new coronavirus, patient advocates and industry observers said. Across the country, more than one in four nursing homes have registered an outbreak, according to media reports. More than 16,000 nursing home residents and workers have died, accounting for 17% of COVID-19 deaths nationwide, according to an AARP tally on May 18. That figure is likely an understatement of the true scope of the harm.