I was not at all surprised to learn about the falsification of COVID-19 testing at a local elder care facility recently reported by the Cleveland Jewish News (“Former Montefiore administrator under investigation,” Nov. 20).

The current pandemic represents a stress test that exposes the chronic issues that plague residential elder care facilities and nursing homes nationwide and here at home.

These issues include maximizing revenue over care via industry-wide low wages ($11 to 12 per hour), which results in absenteeism and extended shifts for caregivers who are present, as well as chronic under-staffing, which is budget-friendly.

In Ohio, it is legal and routine for one aide to toilet, dress, provide incontinence care and choreograph meals for 30 people on an extended shift.

With low staffing ratios, it is common for unsupervised residents to fall and sustain injuries. These injuries are not rigorously assessed, and the circumstances often poorly documented, so as not to incur outlier statistics. Administrators regularly admonish aides not to speak to families about lapses that led to injuries or poor outcomes. Family involvement is sometimes the only quality control, but with COVID-19 visitor restrictions, there is less scrutiny than usual.

The New York Times has detailed how nursing homes have evicted unprofitable residents in the middle of a pandemic.

The false COVID-19 tests exposing elderly residents to 34 positive cases is another example of the self-serving culture of long-term care facilities.

Jane Birnkrant

Moreland Hills

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