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which 5 states? i feel like you have a credibility problem because you are so clearly politically partisan.
i like to think that not being a partisan gives me more credibility but i guess i have no idea what other people's opinion is of my credibility. i get interesting reactions when i start talking politics.
Those 5 governors made awful decisions - it just seems partisan only because those 5 happen to be democrat governors.
I'm from NJ and moved to CA 2 months ago. I really how miss how life was safe in NJ. NJ never had any real natural disasters unless you lived near the shore and also NJ is safe in terms of not being ghetto.
I had to re-read this to see if it was maybe, a joke? NJ not ghetto? PUHHLLEEEZE! Camden, Newark, many parts of Jersey City, Trenton, Elizabeth, many parts of Atlantic City...not to mention lower degree ghetto/trashy places such as Dover, Hudson County areas, parts of the Plainfield area...shall I go on? You have got to be kidding.
Also, how can anyone be "happy" to live in a state that counts itself among the states with the highest property taxes in the country, the dreadful "affordable housing" court mandate which essentially destroys local democracy and local township sovereignty, thereby forcing low income types and ghetto trash into the once-nice suburban areas, fees for everything, rules rules rules and more rules except for criminal thugs who get a slap on the wrist (if prosecuted at all)? If you suffer a home invasion in NJ, good luck because there is no castle doctrine and the criminal has the upper hand.
Christie was a disaster for NJ, as is Murphy. NJ voters are similar to NY voters: dumb and ignorant. They continue to vote for the same crooks who raise taxes and go after honest business owners rather than violent thugs and other undesirables.
NJ also has too many Section 8 types now in every town, whether you want to or not. As if all of the above were not enough of a turn-off, it's also expensive as hell to live in NJ, so you basically are either very wealthy or poor, very few in between (those who are tend to be public employees, milking the taxpayer).
I would never spend my hard earned money buying property in a tyrannical state like NJ.
no doubt it the boat/hotels would have been far from ideal but they also need to breath and covid can stop that from happening. maybe keep them there for a certain period of time (14 days or whatever) before transitioning them back into the nursing home.
im not sure what hospitals do when they dont have a place to discharge a patient but id imagine they have to stay in the hospital until they do. so i think that would have been the first place to keep them.
im not big on assigning blame (i just assume the government is to blame) but people knew what was going to happen before it became news. i remember my brother came into my office and said that the city is killing all of these nursing home patients.
Well the hospitals would not have wanted them because Medicare would not have reimbursed them once they no longer required acute care. I suppose the Feds could have changed Medicare reimbursement temporarily but they didn't do that. Without a reimbursement source they'd have lost tens of thousands for each person they kept.
But again, the boat/hotel wouldn't have been not just "not ideal" it just couldn't have worked. They weren't staffed for that, and they had no equipment for skilled care. None could have been left behind closed doors in a hotel unless they had 1-1 aides for every single one who sat there and watched them 24/7. At their peak infection, NY was so short of nurses for hospitals they were offering $10,000 a week for travel nurses, no way they were going to staff and equip a high school gym to offer the degree of care a nursing home does.
I just think it's easy to Monday morning quarterback, but it really is more complicated than simply "they shouldn't have been sent there".
45 other states dealt with nursing homes using common sense.
please don't defend why 5 idiot Democrat governors went in a different direction, and put sick people among literally the most vulnerable.
Roughly 30,000 people died for literally no reason beyond just being in the wrong place/wrong time... and because those 5 governors decided to kill them.
Cuomo/Murphy both have to be destroyed for what they did. yet our corrupt media will never attack them.
Those governors had more time to prepare and enough PPE by the time they got hit.
At their peak infection, NY was so short of nurses for hospitals they were offering $10,000 a week for travel nurses, no way they were going to staff and equip a high school gym to offer the degree of care a nursing home does.
nursing shortages are fabricated by government, no? they are the ones that tell facilities and other providers how many nurses they need per patient or what nurses are required to do. i know some changes were made to some requirements but i dont know if enough was done to allow places to service patients with less nurses.
whether its being done to criticize politicians or just to evaluate if things could be done better, its important to review things to see if we can do things better next time. i think government regulation is a tremendous problem when it comes to providing services and having capacity for a situation like this. i feel like that isnt going to be addressed.
nursing shortages are fabricated by government, no? they are the ones that tell facilities and other providers how many nurses they need per patient or what nurses are required to do. i know some changes were made to some requirements but i dont know if enough was done to allow places to service patients with less nurses.
whether its being done to criticize politicians or just to evaluate if things could be done better, its important to review things to see if we can do things better next time. i think government regulation is a tremendous problem when it comes to providing services and having capacity for a situation like this. i feel like that isnt going to be addressed.
States set minimums for number of nurses needed per patient (of course it varies with different areas of care) but I don't see how that makes shortages fabricated. There is no one telling anyone to hire only the state minimum, any facility can have as many nurses as they care to pay for. The state only says you must have at least a certain number. per patient.
I don't think regulations are the problem, in fact to me they are a joke. I think a bigger factor is the amount of money that has been cut from Medicare and Medicaid reimbursement to nursing homes. Many, especially those that primarily take Medicaid patients, actually operate at a loss for many of the patients they take. And Medicare reimbursement is getting ready to get cut again, they are cutting therapy reimbursement for long term patients by another 9%. Every cut makes care worse. I've seen the changes firsthand over the past several years. One nursing home industry magazine I subscribe to predicts as many as 40% of nursing homes may go under in the near future. In rural states, already spouses with dementia are being sent to live in homes 2-3 hours from their spouse because they are the closest ones with empty beds. Nursing homes are cutting care to the bone as it is, giving them less regulations will only accelerate poor care.
So combine the lack of money to prepare, the lack of PPE (while people were making homemade masks and hand sanitizers to donate to hospitals, nursing homes were mostly ignored), very low paid staff who often work at more than one home, it is easy to see how this happened.
States set minimums for number of nurses needed per patient (of course it varies with different areas of care) but I don't see how that makes shortages fabricated. There is no one telling anyone to hire only the state minimum, any facility can have as many nurses as they care to pay for. The state only says you must have at least a certain number. per patient.
they are fabricated because if the minimums are raised, magically you have more capacity in your facility to care for patients. also, shortages of beds are created by government because they are the ones that limit the number of beds that a facility can have and limit the amount of facilities that can open.
reimbursement is certainly a big issue and will likely get even worse but im not sure how much of it impacted coronavirus response. the payers basically only want to pay the bare minimum to pay for the workers and leaves little money to put into quality improvement. its hard for anyone but large providers to make that work and even they find it very difficult with the way care is reimbursed these days.
they are fabricated because if the minimums are raised, magically you have more capacity in your facility to care for patients. also, shortages of beds are created by government because they are the ones that limit the number of beds that a facility can have and limit the amount of facilities that can open.
reimbursement is certainly a big issue and will likely get even worse but im not sure how much of it impacted coronavirus response. the payers basically only want to pay the bare minimum to pay for the workers and leaves little money to put into quality improvement. its hard for anyone but large providers to make that work and even they find it very difficult with the way care is reimbursed these days.
The second part is correct, facilities only pay out what they have to. So if there were no minimums set for nurses and nurses aides, you’d have resident’s lying in poop for 2 hours instead of 40 minutes. They don’t prevent the facilities from verifying beds, but yes to designate a bed as Medicare (short term rehab) or Medicaid you have to apply to the state and they have to meet certain criteria (For instance a short term rehab bed requires more nurses because people have more severe medical needs).
But regarding Covid, the biggest problems were that they waited too long to ban visitors and quarantine residents, and the lack of PPE. Dining rooms, activities and hairdressers should have been closed very early on. Nurses aides, who go in and out of 10 to 15 patients rooms all day long, were being given one mask to wear for an entire week in many cases.
If they had had more time to prepare, I think it would’ve been very different. They would have had time to rearrange residents so that they could create a quarantine section. This would have, along with all residents being quarantined and having dedicated nursing just for that wing, severely limited the infection. It’s always easier to formulate a plan when you can see what others did wrong in hindsight. It’s tough to go first and this was especially true with Covid.
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