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Skilled Nursing Facilities (SNF)

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Skilled Nursing Facilities (SNF)

GSA Member's Senate Testimony Highlights Nursing Home Needs During Pandemic and Beyond

05/21/2020

Speaking today at a hearing of the U.S. Senate Special Committee on Aging, University of Chicago professor R. Tamara Konetzka, PhD, told lawmakers about the relationship between nursing home quality and COVID-19, and shared measures to reduce the effects of the pandemic on nursing homes.

Senators convened the hearing, titled "Caring for Seniors Amid the COVID-19 Crisis," to investigate the disproportionate harm older adults across the country are experiencing due to COVID-19 and explore what can be done to better protect this population.

Nursing home Covid-19 deaths – the NY Times data shouts – but what is it saying?

Try staring at the NY Times list and its murky map.  The NY Times decided that tracking down and mapping the list of nursing home deaths nationwide required more than 30 contributing writers for the story. The ‘Nursing Homes in Crisis’ collection is about Covid-19 in 2020. Actually in each recent year, the New York Times has looked at nursing homes and found them to be a problem in 2017wanting for a great deal in 2018, just a bit in 2019, then an onslaught of investigation most recently.  Amid the outcry, the negative comments about bad management, bad physical design of the buildings, bad for-profit ownership, bad Covid-19 testing, etc., etc. -- very little deep thought about why people live there and what change is likely.

Nursing homes and Covid-19 – defensiveness persists 

Nursing homes – consternation, condemnation are words that rule the day. Rant on. It must be tough to be focal points for nursing home policy these days. Even as a task force is being set up to focus on nursing homes, on the one hand, that seems positive. On the other hand, Leading Age CEO was 'enraged' about shortages of PPE.  And seniors (AARP) who are most likely NOT in nursing homes, demand that workers have adequate PPE, that the public be notified which nursing homes have cases of Covid-19, workers are striking at nursing homes, and so on. Go back to 2019, for just a moment. What were the top issues early in the year?  "Challenges facing nursing homes serving primarily long-stay residents covered by Medicaid; workforce challenges, which are unlikely to dissipate; nursing home regulations; and the growing popularity of Medicare Advantage."

Nursing home transparency needs more than Covid-19 case-counting

No understatement, these are very difficult times for nursing homes. First off, thousands of residents have died, and news media organizations are now obsessed with counting and re-counting, totaling up the numbers (more than 10,000 as of today) and then counting some more. So many of the 1.5 million residents of nursing homes were already very frail people, needing help with 3 or more ADLs. 72% of residents are women, most are age 85+, and as noted, 'many also have only a small group of family and friends for support.' Yet there are people who should know better lined up to bash their performance at managing this virus: "If there was any type of senior-care facility that should have been most equipped to manage the COVID crisis, it should have been skilled nursing facilities," said Brian Lee, a former Florida long-term care ombudsman who currently is a member of an advocacy group called Families for Better Care." Right.

Covid-19 – Technology changes accelerate – some a work-in-progress

Note the wave of announcements of 'free' tech services and sea changes. A number of companies popped into my inbox in the past week with announcements of a period of free access to remote care/engagement technologies – including and in alphabetical order CareCentrix, CareTree, Ergo, Eversound, Outpatient, Ready RespondersNurseCaller, Touchtown, StaySmartCare, See You Link and VitalTech. If your firm is in the remote care/caregiving space (health, telehealth, engagement), please comment or email and I will add to this list. And our family doctor’s staff initiated an offer of a Facetime (or Skype or Hangouts or other choice) for a follow-up visit instead of going into the office. Note the other ‘temporary’ change of reimbursement for remote (even telephone) visits, now fitting into the concept of telehealth. The ‘tipping point’ of telehealth is here – and tipping with a suddenness that is unnerving for overstretched vendors and most notably, difficult for providers who may lack the equipment and/or processes to deal with patients remotely, despite the risks to themselves with in-person interaction.

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