Long-Term Care Providers Are on the Front Lines and Must Be Prioritized

May 13, 2020

By Mark Parkinson, President and CEO, American Health Care Association and National Center for Assisted Living 

COVID-19 is the greatest public health threat our country has faced in most of our lifetimes. Health care workers at skilled nursing and assisted living facilities are on the front line of this pandemic.

You can’t turn on the news without seeing a tragic report of nursing home residents and staff confronting the COVID-19 outbreak and the deaths that follow. Sadly, these outbreaks are happening at long-term care facilities across the country. News reports and various data point to more than 3,000 long term care facilities, as of April 20, that have been ravaged by an outbreak and the number is rising each day. The truth is that nursing homes have not failed America. The public health system has failed nursing homes.

A common thread in many news stories is that nursing homes have been impacted by the pandemic in an outsized manner, in part due to the vulnerability of residents and patients who are cared for by employees and staff. Another storyline which has played out in coverage is the lack of available and timely testing as well as personal protective equipment. While this has been true for caregivers across the health care spectrum, it has been exacerbated at long term care facilities.

Despite these unprecedented challenges, nursing and assisted living caregivers have undertaken heroic work to protect residents during the pandemic. While no amount of planning could have adequately prepared any of us for this historic threat, nursing homes and assisted living communities have been on the literal front lines in battling COVID and protecting an extremely fragile population. This has received much less attention and assistance from the public health system as the crisis has unfolded. At every turn, the resources that we have needed to fight this battle have been denied. And our residents, and some staff members, have paid the ultimate cost.

The outbreaks happening in long-term care facilities are the result of a combination of the behavior of this virus and the unique threat it presents to the people we care for — older adults with multiple underlying health conditions.

It is not too late to change the emerging trend in nursing homes and other long-term care settings. Just as we’ve been able to flatten the curve of COVID-19 among the general public, we can do the same in nursing homes and assisted living communities. To prevent overwhelming our hospitals, our public health care system must be more proactive and target our energies and resources on long term care.

There are three immediate steps that must be taken. First, the health care workers in these facilities must get the PPE — particularly masks, gowns and face shields — that are essential to keep the virus out and to keep it from spreading. More than 70 percent of long-term care providers do not have adequate PPE today and cannot get it because we are not considered a top priority for supplies. Despite the vulnerable population we serve, the public health system has put long-term care providers near the bottom of the priority list for equipment. Public health systems across the country should immediately shift resources from less hard-hit providers that are adequately supplied and direct them to long term care providers that need them.

Second, long-term care residents and staff must be a priority for testing. Current Centers for Disease Control and Prevention guidelines do not consider our extremely vulnerable residents and our health care workers as a top priority for testing. Because of the limited availability of testing, many individuals and facilities have had to wait as long as 10 days for results, precious time that would have helped facilities in identifying and containing the spread of the virus. Without being told to make us priority one, labs cannot process our tests quickly and it takes far too long to obtain testing and results. Long term care residents and workers must be the top priority for immediate testing.

Finally, long-term care facilities need help coping with workforce shortages. We need the same staffing support that hospitals are receiving from Federal Emergency Management Agency, the National Guard and volunteer corps. Because of delays in testing and inadequate PPE, many long-term care workers have become ill or are quarantined and cannot return to work. In order to provide the care that our residents need, we need public health leaders to direct staffing resources to our facilities.

As a former governor, I know that state leaders can help as well. I encourage every state to follow the lead of the governors in Maryland and Virginia. Both states have created specific plans for getting long-term care centers the testing, equipment and staffing they need. Congress and the federal government have been helpful with funding and other specific needs, but more needs to be done.

For too long, the public health system has ignored long-term care providers. The results are tragic, but predictable. We have been calling for help from the beginning of the pandemic. Long-term care facilities are doing everything possible to stop the spread of this virus. But we need help. It means saving the lives of the greatest generation. We owe them everything we can muster, and we must do it together.

Originally published in Morning Consult.