Skilled Nursing Facilities (SNF)

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.

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 Responders, NurseCaller, 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.

​Consider CMS Five Star Rating system and how it ‘serves’ families.  Rant on.  No doubt you know someone who was baffled at how a terrible nursing home gets a 4 or 5 star rating from CMS’s Five Star Rating System, while a good one can appear to have a lower rating, applied from an inspection before management overhaul several years earlier.  Why, you ask? Indeed.  Others have asked as well – noting the obvious missing link, family satisfaction with the nursing home, including dealing with the staff. For starters. Retiring outdated information, next. 

For a Chief Medical Officer, what role does technology play? Recently there was an opportunity to query executives in senior care, including Dr. Arif Nazir, Chief Medical Officer, Signature HealthCARE, who was asked about the technology impact on long-term care jobs.   The insights quoted here could be generalized, not just to Skilled Nursing Facilities, but to all types of care delivery – and are particularly notable in the context of last week’s New York Times article: "How Tech Can Turn Doctors into Clerical Workers.” As Dr. Nazir notes, it’s not just doctors who can be frustrated by over-emphasis on technology. Here are the questions and few observations about the work and the workers: