COVID-19 has drastically impacted senior living and skilled nursing providers, reshaping the way care is delivered. As this landscape continues to evolve, providers must apply lessons learned and adjust to match its shifting surface.
To help define the new terrain of care, Mark Parkinson, president and chief executive officer of the American Health Care Association (AHCA), and Kevin Scalia, executive vice president of corporate development at Netsmart, discussed in a recent webinar how organizations can work to increase census and survive in this new frontier.
Below are some of the some of the key takeaways from this dynamic conversation.
How can organizations financially survive the pandemic? What advice do you have for people living through this time as a former operator yourself?
Although Parkinson noted that there is no mold for how organizations approach regaining lost census caused by COVID-19, he emphasized the vital importance of continued federal funding to both senior living and skilled nursing providers.
Additionally, on an operational level, Parkinson advocated for organizations to view reasonable testing requirements as a boon rather than a burden, stating, “I think, at a medium run, it’s going to be beneficial. I think it’s going to lower COVID in our buildings, and I think it’s going to increase the confidence of the public in coming into our buildings.” For Parkinson, testing once a week in a community with significant COVID-19 infection is feasible, with any additional testing mandates proving impractical.
As testing quells public fears, organizations should also return to reinstating marketing measures targeted toward referral sources, encouraging new admissions and re-instilling faith in post-acute organizations.
What are the learnings that skilled nursing operators can take away from the retrospective studies of the varying infection rates in assisted living and independent living communities?
Parkinson points to the infection spread in both assisted living and independent living communities originating from the lack of awareness of asymptomatic spreaders. Despite the most stringent infection control measures, COVID-19 was spreading among communities as staff dressed, socialized, hugged and dined.
While this was the reality in both assisted and independent living communities, Parkinson nods to lower infection rates in assisted living communities as a learning curve for other care facilities, indicating lower numbers of staff and less interaction with residents as key factors in reduced infection rates. He also noted that the existence of single rooms in assisted living organizations provided contained structures conducive to quarantine.
In the future, Parkinson hopes there will be “a real look at building nursing homes with private rooms.” He adds “the dollar amount between a private room and a shared room, from a construction and development point of view, is not as much as one might think.”
In addition to a transition to private rooms, Parkinson also believes that Centers for Medicare and Medicaid Services (CMS) will mandate a requirement regarding protective personal equipment (PPE) storage. Even if this does not come to legal fruition, Parkinson urges organization to store at least three months-worth of PPE.
Lastly, Parkinson points toward the likelihood of increased infection control standards. “We’ve encouraged the government to not reduce requirements on infection control,” said Parkinson. “In fact, we’re advocating for more infection control in buildings in the future.”
While providers can learn from these shared experiences and recommendations, Parkinson also advocates for an introspective reflection, stating “I think the most important thing that can come out of this is that we look in the mirror. Don’t just blame others…we have to look at ourselves and say are there things that we can do to be better. And if we go in with that attitude, we can make this better.”
With more than 3,400 COVID-19-related lawsuits across all lines of business, and with senior living at the center of that storm, how can operators protect their organizations?
Parkinson advocated heavily for liability insurance. Although this insurance doesn’t ensure complete immunity, it protects against the most financially devastating outcomes.
In addition to liability insurance, Parkinson urges organizations to communicate with their liability provider, to delineate best practices. This conversation should extend to outside legal counsel, asking for defined advice for protocol within buildings.
Lastly, Parkinson doubles down on his previous answer regarding testing, stating that “I would be testing staff once a week.” This initiative not only allows for increased public faith and slows disease spread, but also creates visible data that can be used to underline that an organization is enacting all possible measures to ensure safety.
What advice do you have for operators for dealing with balancing the budget? What were your learnings from your time as Governor during a financial downturn?
Parkinson urges providers to double their political activities, advocating for collaboration with state agencies to work together to stave off Medicaid cuts in 2021. He advised providers to get involved, asking local agencies “What is the plan? I want to be part of the plan.”
“Governors are going to be under pressure to cut a million things,” said Parkinson. “[You] have to stand out as the one thing that cannot be cut.” To achieve this visibility, Parkinson argues for providers to be loud, to double down on lobbying efforts.
Throughout this conversation, Parkinson provided operators with a multitude of tangible strategies for improving census and surviving post-COVID-19. While the outlook may seem daunting, Parkinson is also confident in the sector’s regenerative ability, stating “the last six months have been pure hell. But we are about halfway through the nightmare. By March of 2021, we are going to be in a much better place. The next six months is going to be us winning against the virus. We’ll get better news on testing, better news on treatment.”
To watch the webinar in its entirety, please follow this link.
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