Legal Blog

Long-Term Care: A Crisis Within the COVID-19 Crisis | Part 1 – What We Know

By now everyone has, hopefully, adjusted to the new restrictive reality of COVID-19 and is itchy to inch out into the new freedom offered by the cry to “opening up commerce” whatever that means in the unfolding new normal wherever you may be. However, do not be fooled. Due to the earlier than expected opening of society, the University of Washington, Institute for Health Metrics and Evaluation, has revised its projection of COVID-19 related deaths from approximately 72,000 to 134,000 by August. These projections are obviously conservative given we have reached over 70,000 by early May. Merely because the northeast corridor curve has been bent, this is not over, and vigilance must be maintained. Some sections of the country are just beginning to confront this crisis as hot spots pop up throughout the south and midwest, not to mention a possible second wave this summer and a predicted fall wave.

For the long-term care (LTC) community, the crises continue. It has been the epicenter of over half of all COVID-19 deaths, many under-reported and unreported. Reports of families not being notified, stacked bodies being delivered to the medical examiners in open pick-up trucks, National Guard personnel being ordered  into nursing and veterans’ homes, regulatory and criminal investigation commencing, coroners and state regulators clashing over the use of scarce testing to determine the cause of death continue and appear to be the tip of the iceberg given the lack of transparency. These stories continue across the country in every jurisdiction. The LTC is, currently, not capable of dealing with this or any pandemic.

This crisis is not limited to nursing homes, but also impacts assisted living facilities, personal care homes, as well as group homes and congregate living arrangements involving those with mental health issues, the intellectually disabled, committed juveniles and others. The LTC and Behavioral Health industries, along with their regulators and funding sources, in addition to confronting the challenging task at hand, must also be preparing to address the future to ensure that the fragile lives entrusted to them are never again subject to such a threat no matter the cause.

Considerations include but are not limited to:

  • Provider Immunity and Standard of Care;
  • Facilities Redesign and Modifications;
  • Restructuring Programming, Protocols and Models of Care;
  • Licensing and Regulatory modifications are all on the table.

It is imperative that the provider community and industry leaders begin to take the lead on these issues rather than the regulators dragging them into a new environment navigating an unreasonable and unworkable landscape. The provider community must think and plan. Follow me in this multi-part series of blog posts as I discuss the major issues defined impacting the LTC and Behavioral Health industries regarding the COVID-19 pandemic.

If you have any questions or concerns regarding LTC and the Behavioral Health industry please reach out to me at and follow along with the series for more COVID-19 related content.

Read part one here »


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