COVID-19 Updates

AHCA/NCAL Addresses COVID-19 Issues Related To LTC Facilities

AHCA/NCAL continues to address LTC coronavirus issues. For example, Managed Health care Executive (5/18, Loria) reported American Health Care Association/National Center For Assisted Living (AHCA/NCAL) president and CEO Mark Parkinson tweeted, “People will end up blaming nursing homes and talking about how terrible we are, but it is the complete lack of prioritization that has put us in the position we are in.” AHCA/NCAL spokesperson Beth Martino “says nursing homes are doing everything they can with the resources they have been given to slow the spread of the virus.” According to Martino, “Our providers are struggling due to lack of testing, insufficient personal protective equipment (PPE) and a workforce shortage due to school closures and employee illness. … We desperately need more PPE in nursing homes, priority testing for our health care workers and residents, and the ability to quickly recruit and hire more staff.”

        WCJB-TV Gainesville, FL (5/15, Riepenhoff, Zurik) reported that Parkinson “said past infection-related deficiencies have no bearing on the present crisis in nursing homes.” According to Parkinson, “The constant, continued criticism of a really flawed past survey system has nothing to do with what caused this. … The only way we would have stopped this is if we had less COVID-19 in the community.”

In Some States, Assisted Living Communities Have Not Been Included In State COVID-19 Testing, Data Initiatives

McKnight’s Senior Living (5/19, Bonvissuto) reports, “Associations representing assisted living operators are calling attention to the fact that in some states, assisted living communities are being left out of testing and data initiatives.” For example, “at the national level, AMDA -The Society for Post-Acute and Long-Term Care Medicine, said that although some states are issuing orders for universal COVID-19 testing at assisted living communities and nursing homes, testing needs to be part of a broader strategy to address costs, staffing, frequency and type of tests.” Moreover, in Virginia, one organization “published a ‘Licensed Nursing Homes Dashboard’ from the Virginia Hospital Alerting and Status System that shows COVID-19 cases and personal protective equipment needs across the state.” However, the Virginia Health Care Association – Virginia Center for Assisted Living, along with other organizations, “said the dashboard, which is based on data voluntarily provided by long-term care facilities reporting to VHASS, ‘shows only a partial picture of the ongoing needs of Virginia’s long-term care facilities.’”

Member Organizations Continue To Respond To Coronavirus

Throughout the US, AHCA/NCAL members continue to address COVID-19 issues faced by facilities. For instance, McKnight’s Long Term Care News (5/18, Brown) reported, “New York providers are calling on state officials to provide ‘full assistance’ following a new mandate to test workers twice a week – something they say is nearly ‘impossible’ to comply without help.” The order from Gov. Andrew Cuomo “would require more than 410,000 COVID-19 tests every week, and that amount of testing means officials would need to increase the on-site availability of testing for providers, explained Stephen Hanse, president and CEO of the New York State Health Facilities Association and New York State Center for Assisted Living.” Hanse said, “The state must ensure that enough tests will be available in a timely manner and that it will fully cover the costs of these tests. Providers are seeing costs of $150 per test – resulting in a potential $60 million a week cost that is unsustainable and is an existential threat to the economic viability of skilled nursing and assisted living providers throughout New York.”

        The Hagerstown (MD) Herald-Mail Media (5/17, Steven Lemongello, 32K) reported Florida Governor “DeSantis said last week he was trying to determine how to allow visitors at nursing homes and other long-term care facilities for the first time since the start of the coronavirus outbreak.” Florida Health Care Association executive director Emmett Reed “said the ultimate solution could be some combination of ‘strong screening procedures, testing, proper infection controls and PPE (personal protective equipment), designated areas with appropriate social distancing, along with a process that is facility and community-specific based on the impact of COVID-19.’”

        The Roanoke (VA) Times (5/16, Rife, 207K) reported Virginia Health Care Association/Virginia Center for Assisted Living CEO Keith Hare said, “We did what we were supposed to do. We locked the facilities down in terms of visitors. We already had infection-control measures in place, but we put in additional measures.” Hare also “said the majority of the people living in Virginia’s nursing homes are very poor and incredibly sick and frail, and they have multiple illnesses.” According to Hare, “We started in this virus without the level of personal protective equipment we needed. We tried to obtain additional supply lines. We were cut off. … Then on top of that there had been significant lack of testing.”

        The Roanoke (VA) Times (5/18, Rife, 207K) reported Hare said, “Virginia’s long-term care providers – both nursing homes and assisted living facilities – are working every day to stop the spread of COVID-19 and follow proper infection control procedures while making sure our residents still receive the daily care they require.”

MA Plans May Help Prevent Hospitalizations, Experts Say

Senior Housing News (5/19, Regan) reports, “The [COVID-19] pandemic has created new risks for providers of Medicare Advantage (MA) plans – but those plans are also proving their value and may still be a major future component of senior living,” according to “the message from some of the most prominent players that have been pushing for increased MA integration in senior living over the past several years.” One expert said that “having MA plans now has helped some providers deal with the global pandemic and keep some of their residents out of the hospital.” Another expert “emphasizes that MA benefit packages demand and support more robust and integrated clinical platforms that prevent hospitalizations – always important in senior living, but even more critical during a pandemic.”

CMS Has Updated MDS, Related Technical Specs, But Providers May Be In “Limbo” Waiting For Additional Info, Expert Says

McKnight’s Long Term Care News (5/19, Brown) reports, “The Centers for Medicare & Medicaid Services has updated MDS 3.0 items (version 1.17.2) along with related technical data specifications.” However, “providers could be left in ‘limbo’ as they await for more information regarding the changes from their state Medicaid agencies, according to one expert.” The CMS “changes will support the calculation of Patient Driven Payment Model payment codes on OBRA [Omnibus Budget Reconciliation Act] assessments when not combined with the five-day SNF PPS assessment, specifically the OBRA comprehensive (NC) and OBRA quarterly (NQ) assessment item sets.”

Patients Testing Positive For COVID-19 A Second Time May Not Be Contagious, Research Indicates

The Hill (5/19, Weixel, 2.98M) reports that “researchers in Korea found evidence that patients who test positive for COVID-19 a second time aren’t capable of infecting others, and may have neutralizing antibodies that protect them from getting sick again.” The scientists from the Korean Centers for Disease Control and Prevention “studied 285 patients who had survived COVID-19, but subsequently tested positive after multiple negative tests showed they had supposedly recovered.” The researchers “found a total of 790 contacts, none of whom tested positive as a result of being exposed to the ‘reinfected’ patients.”

Use Of Surgical Masks May Reduce Spread Of Coronavirus Up To 75%, Research Indicates

The Hill (5/19, Budryk, 2.98M) reports, “A study by Hong Kong researchers suggests wearing surgical masks can reduce the spread of coronavirus by up to 75 percent.” In a study using cages of hamsters, the researchers found “without any masks between the cages, two-thirds of the healthy group were infected within a week, but with masks over the cage with the infected group, the infection rate of the healthy group fell to just over 15 percent.” Moreover, “the infection rate dropped by about 35 percent when hamsters were placed on the healthy group’s cage.”

Studies Suggest Speech May Spread COVID-19 More Than Feces

Medscape (5/19, Subscription Publication, 277K) reports that a study published in PNAS found that “normal human speech emits droplets capable of carrying the novel coronavirus (SARS-CoV-2) that causes COVID-19.” Researchers found “the droplets lingered in the air for up to 14 minutes…which could help explain why the disease has spread so rapidly.” Meanwhile, a separate study published in Science Immunology “turned up no infectious particles of SARS-CoV-2 in stool samples.” Medscape says “the findings could provide clues about how best to limit the disease’s spread.” Andrew Noymer, PhD, MSc, associate professor of population health and disease prevention at the University of California, Irvine, said: “Fecal–oral is not a happening thing. I think this reinforces the importance of masking.”

Older Adults With Self-Reported Visual Impairment, Dementia May Have Higher Disability Risk, Study Suggests

McKnight’s Long Term Care News (5/19, Lasek) reports, “Elders with dementia and self-reported visual impairment may be at higher risk for disability, and may benefit from interventions to maximize vision and functioning, say investigators” in a recent study. The researchers wrote that “individuals with dementia and visual impairment were less functional in mobility, self-care, and household activities than their peers with either condition alone.” The study was published in JAMA Ophthalmology.

LTC Communities, Volunteers Find Unique Ways To Lift Residents’ Spirits

Throughout the US, care providers and volunteers continue to maintain interaction with residents, using creativity to bring joy to their days. For instance, WFMY-TV Greensboro, NC (5/18, 145K) reported the staff in one LTC community “arranged a timeless photoshoot to have fun with their senior residents while celebrating the graduating class of 2020.” Using “borrowed caps and gowns, a backdrop, and cellphone camera,” their smiles were “captured…as a way to spread cheer during such uncertain times.” In addition, the older adults “also posed with giant whiteboards offering great advice for the graduating class,” including messages like, “Stay Humble,” and “Do Your Best.”

        WKYC-TV Cleveland (5/18, 223K) reported, “With visitors no longer permitted at nursing homes amid coronavirus concerns, the staff at” one health care center “found a creative way to help their residents smile: Hallway dancing.” Several “recent videos posted to their Facebook page shows workers dancing throughout the hallway…while residents join from the doorway of their rooms.” The facility’s administrator “said the staff intends to continue doing hallway dances to different songs every Friday.”

        The Bristol (VA) Herald Courier (5/19, Rothrock, 25K) reports the activities director at one LTC community “said employees had seen where some nursing homes were painting hearts on windows and liked the idea. So they recruited artistic volunteers to paint the center’s windows.” The facility’s “residents voted on the theme, choosing between Disney characters, sports or their own idea,” and chose Disney. Throughout “the building, beloved characters like Snow White and the Seven Dwarfs, Cinderella, Olaf, Ariel and Minnie Mouse dance from window to window, much to the delight of residents and staff.”

        The Northbrook (IL) Patch (5/18, 1.03M) reported a fifth-grade teacher in Illinois “recently had her students participate in an intergenerational project with senior residents at” a local LTC facility “focused on ‘Lives Well Lived,’ named after a new film.” Some students “were already working on a project that focused on life in the 1930s” while “other classes worked on their parts, which included patriotism and hobbies of the 1940s,” according to a press release. Then, “the students shared what they learned with the residents…asked them many questions,” and “then recorded it on their iPads at home” for the residents to view.

        The Beatrice (NE) Daily Sun (5/18, Brich, 14K) reported that at some SNF facilities in Nebraska, “several individuals helped parade animals including a goat, sheep, horse, turkey, chicken, bunny and turtle outside residents’ windows, and received several waves and smiles in response.”

        WSAZ-TV Huntington, WV (5/17, 166K) reported an Ohio skilled nursing and rehab center “created a visitation station allowing families to somewhat reunite with their loved ones.” This facility “created three plexiglass panels that create a safe environment inside the plexiglass for the patient.” Visitors may “come visit with their loved ones on a scheduled basis and must call to schedule an appointment.”