Virginia Ranks 41st Nationally in Nursing Home Ratings

by Carol J. Bova

Medicare offers a “Nursing Home Compare” website. It uses a one- to five-star rating system for four categories: Overall Rating, Health Inspections, Staffing,  and Quality Measures. There is a category called Special Focus Facility for a nursing home with a persistent poor quality of care, subject to more frequent inspections and escalating fines. New nursing homes are unrated until more information is available. The website reports also include facility details, ownership, inspections, deficiencies, and fines.

The list below combines the percentage of special focus, one and two star (below average and much below average) nursing homes in one column, three, four and five star (average, above average and much above average) nursing homes in the second, and the percentage of new unrated facilities in the third for the 50 states and the District of Columbia.

Sorted by overall rating, from best to worst, Virginia ranks 41st in the country with 41.8% of its nursing homes below average. Only Missouri, New Mexico, North Carolina, Mississippi, West Virginia, Kentucky, Oklahoma, Georgia, Texas and Louisiana had more below average facilities than Virginia. Continue reading

New Virginia Battleground in War on Gas

The northern part of the Header Improvement Project. Source: VNG Application at SCC. You can see the full project map here.

By Steve Haner

First published this morning in the Fredericksburg Free Lance-Star.

To the modern environmental movement, natural gas is the Devil’s own breath. It must be opposed in every form on every front.

This explains the existential battle being fought over what would otherwise be considered fairly minor capital enhancements to an existing gas pipeline connecting Northern Virginia and Hampton Roads. Virginia Natural Gas is seeking to increase the capacity of that line with a 6-mile extension to connect to the Transco pipeline near Quantico.

Those six miles are the only new section of pipeline in the Header Improvement Project. Elsewhere, the existing pipeline will see three miles of parallel pipe added to increase capacity in Fauquier County and 14 miles more north and east of Richmond. Three compressor stations are also proposed, one each at the northern and southern ends and one in the middle of the route near Ladysmith. The whole project is priced in at about $345 million.

The objections display hypocrisy. Opponents of the proposed multi-billion dollar Atlantic Coast and Mountain Valley natural gas pipelines have often pointed to the actual or potential capacity of the state’s existing lines. Those are sufficient for Virginia’s needs, they say. The minor proposed improvements strengthen that argument, and logically should be embraced by those opposed to the mega-projects to the south.

Yet VNG’s proposal is drawing the same level of heated opposition as the major projects, with their hundreds of miles of new construction. Even a six-mile extension of an old pipeline is a path to perdition. Continue reading

Juggling the Revenue

By Dick Hall-Sizemore

Jim Bacon mentioned in an earlier post that the state’s revenues for April were $700 million less than in April of last year.  I was surprised that there were no cries of outrage from readers and dire warnings of the state running a budget deficit. I was also surprised that I did not detect any signs of panic on the part of the administration.

After I dug into the details and thought about them for a while, I realized that, for reasons to be set out later, the state is in position to finish this fiscal year in the black. It is next year that has the administration worried.

Total general fund revenues for April 2020 were 26% lower than those for April 2019, leading to the $700 million decrease. Although total General Fund (GF) revenue year-to-date was higher (1.4%) than the comparable period in FY 2019, 3.1% growth for the year is needed to meet the forecast. In summary, the state revenue growth rate through April was less than half what was needed to meet the forecast. Continue reading

A Founder Warned Us; We Did Not Heed the Warning

By Dick Hall-Sizemore

Being retired and staying at home, I have now embarked on a long-planned project—reading the debates of the 1787 Constitutional Convention, as reported by James Madison and a few others.

I have only just started, but it is fascinating already. Many of the issues they discussed and debated are still being tossed around today, including on this blog. One speech I read recently particularly fascinated me.

The subject was whether the members of the first house of Congress should be elected directly by the people. Elbridge Gerry of Massachussetts (he of gerrymandering fame) was opposed to the direct election. Part of his argument, as reported by Madison, went this way:

“The people do not want virtue; but are the dupes of pretended patriots. In Massts. it has been fully confirmed by experience that they are daily misled into the most baneful measures and opinions by the false reports circulated by designing men, and which no one on the spot can refute.”

Elbridge Gerry was obviously a man ahead of his time; he foresaw the rise of social media and warned against it.

2/3 of COVID-19 Deaths Yesterday Traceable to Long-Term Care Settings

According to the latest Virginia Department of Health data:

  • 33 COVID-19-related deaths were reported May 19 and published today.
  • 22 new deaths were reported for long-term care facilities.

That’s just one day’s results. But it’s consistent with yesterday’s data. Can we agree that the COVID-19 epidemic in Virginia is, at this point in time, primarily a nursing home epidemic?

Meanwhile, according to the latest Virginia Hospital and Healthcare Association data, 10 of 262 Virginia’s nursing homes reported having difficulty obtaining N95 masks, 4 had trouble getting surgical masks, 7 finding face shields, and 21 obtaining isolation gowns. Is there a correlation between PPE shortages in nursing homes and the spread of the virus (and resulting deaths) at those same nursing homes? It would be nice if the VDH would make the data public so citizens could find out for themselves.

— JAB

Virginia to Hire 1,000 Contact Tracers. What Will Their Priorities Be?

by James A. Bacon

Virginia is committing $58 million in federal emergency aid to expand contact tracing of people testing positive for the COVID-19 virus, reports the Richmond Times-Dispatch. The epidemic-fighting tool will be all the more necessary as Virginia eases its Vulcan Death Grip on Virginia’s economy and people begin moving around more freely.

“As we interact more, there will be more opportunity for [positive cases] to infect others,” Virginia State health Commissioner Norman Oliver told the Senate Finance & Appropriations Committee yesterday.

The state health department already uses contact tracing to prevent the spread of sexually transmittable diseases, tuberculosis and other communicable diseases. “This is what local health departments do every day,” Oliver told the committee. Hiring 200 communicable disease investigators and 1,000 contact tracers will cost an estimated $7 million to $8 million a month. 

The RTD article did not say how the activities of the contact tracers would be prioritized, presumably because Oliver did not tell the committee. Twelve hundred people sounds like a lot — and maybe it’s more than enough to handle the job. But consider that the number of new COVID-19 cases every day has ranged between 700 and 1,300 over the past couple of weeks. Roughly speaking, that’s one new case per contact tracer per day. Continue reading

Trailing Candidates Should Bail Out, Void Primary

By Steve Haner

More often than not, the suspense in an election is over long before the polls open. That is the case with the two primary contests which will require me to sit in a polling place all day on June 23. The expected losers should just drop out now and save us all the risk.

The precinct where I work has both a Republican and a Democratic contest scheduled, which will require my co-workers and me to be at the polling station from 5 a.m. until 8 p.m. Based on what happened in the local elections yesterday, it will mostly be voting from cars – in a location with very little parking.  Continue reading

Contract Killer Paroled in Virginia

by Kerry Dougherty

Let’s begin today with a quiz:

Where would you rather be during this COVID-19 epidemic, in a nursing home or a Virginia prison?

If you said “prison” you’re right. Of course any place in the commonwealth would be safer than a nursing home. As of 10 a.m. Tuesday, the Virginia Department of Health reported that 614 residents of long-term care facilities had died from the virus. That was an increase of 19 fatalities from Monday.

Horrific.

By contrast, only 5 inmates have died in all of Virginia’s correctional institutions since the beginning of the pandemic.

Yet we’re keeping frail people in nursing homes and letting criminals out of jail.

Meet the latest parolee: Horace Eugene Burnette III, who has the distinction of being the first man convicted of capital murder in Nelson County. He was sentenced in 1992 to life in prison plus 30 years for the murder-for-hire deaths of two women. He was released on April 2. Continue reading

Jerry Falwell Jr., COVID-19 and the Insufferables

Jerry Falwell Jr.

by James A. Bacon

Writing for the Washington Post means never having to say you’re sorry. If you’re looking for examples, consider the case of Jerry Falwell Jr. and his decision to keep Liberty University open during the COVID-19 epidemic, even as virtually all other colleges and universities were shutting down.

“This public response indicates the staggering level of ignorance that informs Falwell’s leadership,” opined columnist Michael Gerson. “It is possible for students with mild or unnoticeable symptoms to spread the disease. … Yes, the fatality rate of infected colleges students is likely to be low. Yes places with broad community spread are more likely to see infection of the elderly and vulnerable, who are more likely to fill premature graves.”

“Irresponsible decisions like Jerry Falwell Jr.’s put untold numbers of people at risk,” ran the headline of a WaPo editorial. “These foolhardy, irresponsible decisions endanger not just those who … resumed their college studies but untold others who now run the risk of the novel coronavirus being passed on to them and their families.”

Liberty University moved most of its classes online. About 1,200 students made the choice to return. The New York Times reported that nearly a dozen students promptly came down “with symptoms that suggested Covid-19,” a factoid that was repeated endlessly in the media and mutated into the assertion that a dozen students actually had contracted the virus. Continue reading

The Epidemic Is Occurring in Nursing Homes, Not the Beach

by James A. Bacon

Here are a couple of data points to chew on. Yesterday, according to the latest data published by the Virginia Department of Health, Virginia recorded 27 deaths from COVID-19. Of those, 19 occurred in long-term care facilities for the elderly. In other words, 70% of the coronavirus-related deaths occurred in long-term care settings.

That’s just one day’s worth of numbers, but it is not atypical.  Over the course of the epidemic, 59% of all deaths were of residents of long-term-care facilities.

By contrast, the big news from Governor Ralph Northam’s Monday press conference was that the Governor will “allow” the City of Virginia Beach to reopen its beaches beginning Friday. But people had better follow the rules, the Governor warned. If they don’t, he “will not hesitate” to slap restrictions back on.

If only there were some way to track how many people contract COVID-19, get hospitalized, and die from frolicking at the beach. The state is in the process of hiring hundreds of contact tracers. It’s not clear yet how they will be used. Perhaps the Governor could deploy some to follow up beach-related infections. That way we could test the proposition, for which there is absolutely no evidence at this point in time, that congregating in the sun and salty air of the beach could reignite the spread of COVID-19. Continue reading

What, Exactly, Is VDEM Doing In the COVID-19 Emergency?

by Carol J. Bova

The Virginia Department of Emergency Management (VDEM) is responsible for writing the Commonwealth of Virginia Emergency Operations Plan (COVEP) which “provides the framework for how the state will support impacted local governments, individuals and businesses.”

A Virginia Municipal League (VML) web page provides Virginia localities a Continuity of Operation Plan (COOP) template from VDEM. The page refers to Va Code Sec. 44-146.18 B.6. which encourages but doesn’t require localities to have a COOP.

This Continuity Plan is a recovery plan and functions as a companion plan to the [Locality’s] Disaster Recovery Plan and the Emergency Operations Plan. The Continuity Plan provides a framework designed to minimize potential impact to operations and allow for rapid recovery from an event, which may or may not cause the activation of emergency response or incident action plans.

“While the Code [of Virginia] refers to VDEM as providing guidance to localities,” writes VML, “the worksheet will have to suffice as that guidance for now – VDEM staff are currently working night-and-day on immediate emergency planning and response. Try instead to work with your local emergency coordinator or work together with a neighboring community if you need to develop your own COOP.”

VDEM staff is working night and day? Administrators are too busy to help local governments figure out how to maintain operations during the COVID-19 emergency? What, then, is VDEM doing? Continue reading

Pass the Coppertone

Virginia Beach, 2016. Photo credit: Kerry Dougherty

by Kerry Dougherty

Virginia Beach is back.

Well, sort of.

At his press conference yesterday Gov. Ralph Northam bent to pressure from irate local politicians, desperate resort businesses and an increasingly disgruntled public by announcing that city beaches could reopen in time for Memorial Day.

“This is the tonic people need right now,” an ebullient Beach Mayor Bobby Dyer told me last evening. “People have been confined for months. Beaches to the north and south of us are open. This had to happen.”

Northam had promised a decision on beach openings on Monday. But Dyer became worried Saturday night when he saw a newspaper photo that seemed to show throngs of people shoulder-to-shoulder on the beach.

“I was down there from 2 to 4 on Saturday and it wasn’t like that,” Dyer said, explaining that when shot with a long camera lens, perspective on crowd size can be distorted. Continue reading

Reopening: Know and Avoid the Risks

Musical chairs goes viral

By DJ Rippert

The Bromage Broadcast. Erin Bromage is a professor of biology and a blogger. She will tell you that she’s not an expert epidemiologist but she recently wrote a blog entry that proves she is an eloquent writer when it comes to explaining the physics of Coronavirus to the layman. As Virginia reopens after the lockdown people will have to make personal decisions about what activities to undertake and what activities to avoid. Ms. Bromage’s plain English explanations make a good starting point for making such decisions.

Continue reading

Nursing Home Data Raises New Questions about COVID-19 Policy

by James A. Bacon

The Virginia Hospital and Healthcare Association has just published a data dashboard focusing on Virginia nursing homes. And the picture it presents is very different from that of the state’s acute care hospitals.

While acute care hospitals have solved their shortages of personal protective equipment, the nursing homes have not. According to the VHHA dashboard, 11 nursing home report difficulty obtaining N95 masks, four obtaining surgical masks, three obtaining gloves, seven obtaining face shields, and 18 laying hands on gloves.

Another noteworthy reveal from the data: The number of active COVID-19 patients currently in nursing homes is almost as large as that in acute care hospitals — 1,427 in nursing homes yesterday (and published today) compared to 1,502 in acute care hospitals.

The dashboard also tells us that 520 nursing home patients have recovered from COVID-19, compared to 4,107 who have recovered from acute care hospitals. Continue reading

Could the Low Testing Numbers Be Telling Us that COVID-19 Is Receding?

by James A. Bacon

Just a couple of weeks ago — under surreal COVID time, who knows how long ago it really was — Governor Ralph Northam told Virginians that he wanted to see 10,000 or more tests per day before relaxing his Vulcan Death Grip on the state economy. With the exception of a single day, a statistical anomaly caused by a catch-up in the reporting of data, Virginia has fallen short of that 10,000 benchmark. Thankfully, the Governor has ignored his own dictum and permitted a timid incremental rollback of his emergency restrictions — not enough to make a big difference, but a step in the right direction.

Judging by the time dedicated to the subject on cable television, there is a national mania for testing. More testing and contact tracing are absolutely imperative if we’re to get out of this COVID-19 mess alive. Perhaps that’s true. If it is, the Northam administration is falling on its face. Testing, rather than inching closer to that 10,000 threshhold over the past couple of weeks, has been trending down, as can be seen plainly in this chart.

Counting the number of tests is more difficult than one would think. For a long time, the Virginia Department of Health was not capturing tests performed by private labs. More recently, it backtracked on lumping together antibody tests with RNA tests. Whatever the case, it is clear that Virginia has yet to reach the 10,000 benchmark.

Here’s the point where readers no doubt expect me to lambaste the Northam team for another administrative failure. I hate to disappoint, but disappoint I must. Continue reading