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 LTC Providers Require More Funding, PPE, Tests as States Weigh Reopening Moves

As states weigh how to reopen their economies after locking down to stop the spread of the COVID-19 virus, the long term care profession said skilled nursing and assisted living providers must have additional support in the way of increased funding, supplies of vital personal protective equipment (PPE), and testing of staff, visitors, and residents before facilities can loosen restrictions.

Even though providers, residents, and families all want to return to a sense of normalcy, doing so must not put residents at increased risk, according to long term care advocates.

AMDA -The Society for Post-Acute and Long-Term Care Medicine, said as states and local communities begin to reopen, the residents and employees of post-acute and long term care facilities, along with their families, will wonder when they too will be able to end no-visitor policies, dine together again, and enjoy group activities and routine visits to the salon.

“Residents of post-acute and long term care (PALTC) facilities remain the most vulnerable population during this ongoing COVID-19 pandemic. While some areas in the country have seen a decline in hospital admissions and deaths from COVID-19, other areas continue to see a rise in cases, hospitalizations, and deaths within PALTC,” AMDA said.

Of all deaths reported in the United States, estimates suggest that some 40 percent to 56 percent are nursing home-related, they noted. “Infectious disease experts warn that the country will experience a second wave of the virus this fall, and it is unclear yet if we will be fully prepared for it. In addition, widespread, reliable testing is still not a reality for many PALTC communities, nor is a consistent supply of personal protective equipment for health care workers in long term care,” AMDA said.

Given these factors, the group said the decision to reopen or to relax social distancing efforts within PALTC communities must be made with great caution and on an individual basis, regardless of the status of the surrounding community.

“This critical decision rests with the people most familiar with residents, staff, and resources—the clinical leaders managing the care of the patients and residents in these facilities,” AMDA said.

To do so, medical directors, executive directors, and directors of nursing, along with their regional leadership, should work in collaboration with their local health departments and hospital systems to determine the appropriate time to reopen their nursing homes and assisted living communities to visitors, to relax social distancing policies and PPE requirements, AMDA said.

“Finally, we urge federal, state, and local governments and health authorities to stipulate that, in the chain of events leading to reopening businesses and buildings, that PALTC facilities, where older adults most at risk of serious illness or death from COVID-19 reside, be the last to open to visitors and outside contractors and vendors,” AMDA said.

Echoing these sentiments, Mark Parkinson, president and chief executive officer (CEO) of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), said there has to be a measured approach to any reopening effort.

“We understand and appreciate the need to begin reopening businesses and getting our country back to work. We appreciate the administration recognizing the impact of reopening plans for our nation’s seniors,” he said. “However, given the gravity of the situation we are facing with this deadly virus and its impact on our vulnerable residents, prior to reopening, it is essential that long term care facilities have additional support and funding from state and federal governments to reduce the spread of this deadly virus.”

Parkinson said the only way for “our health care sector to get ahead of the outbreak of the deadly virus is for priority testing and availability of both collection and testing kits to be expanded to ALL our residents, caregivers, and visitors, as well as assuring expedited test results.”

Without expanded testing, he said, it is virtually impossible for providers to know who in their facilities, whether they are residents, caregivers, or visitors, are COVID-positive—making it extremely difficult to stop the spread of the virus.

“In addition, long term care providers must have adequate supplies of PPE,” Parkinson said. “State and federal governments must help long term care providers get access to more supplies as we wait for some of the manufacturing and supply chain issues to be resolved. Finally, as states begin to reopen, nursing homes and assisted living must have additional staffing to continue providing care to our residents,” he said.

Parkinson said the pandemic has been stressful and difficult for residents and families. And, while providers are eager to welcome visitors and volunteers back into their buildings, “we must ensure that universal testing, PPE, and staffing requirements are met so we can keep our residents safe.”

The way COVID-19 impacts older Americans and puts them most at risk is something that has been clear from the start of the crisis and makes reopening facilities even more of a cautious exercise, said Katie Smith Sloan, president and CEO of Leading Age.

“LeadingAge members have dedicated their lives to keeping them safe and healthy—in nursing homes, assisted living, and other care settings. As states consider reopening, it’s critical that the places where the most vulnerable people live, like nursing homes, move slowly and deliberately in easing restrictions,” she said.

“They must have ample PPE and testing to reopen in a way that protects both residents and staff.”

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