Ongoing Support for Nursing Homes Is Critical to Help Our Seniors

August 31, 2020

The perfect killing machine. That’s what we called COVID-19 when we saw residents in nursing homes becoming infected nearly six months ago. This crisis was unlike anything the health care sector had ever seen. Even with the most rigorous infection control processes, nothing could have prepared us for what was to come.

Those in our care – seniors and those with underlying health conditions – were among the most susceptible to the novel coronavirus, so the heroes in our long-term care facilities did everything in their power to keep the virus at bay from the onset. While critical resources went to overwhelmed hospitals, nursing homes were left pleading for the personal protective equipment (PPE), testing, and staffing they needed to protect residents and caregivers.

We began to sound the alarm. As the death toll in nursing homes climbed, we called on federal and state governments to come to our aid. Finally, after many months, the urgency became clear to officials: long term care providers cannot fight the pandemic alone.

Federal and state funding have helped many nursing homes with the soaring costs associated with combating COVID-19, but ongoing support is the key to preventing more outbreaks. For facilities with positive cases, non-labor costs have more than doubled, while labor costs have increased by an average of 18 percent. Coupled with a sharp decline in revenue, nursing homes face serious financial hardships without continuous support from federal and state governments.

new survey conducted Aug. 8-10 by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) reveals in further detail how nursing homes have been impacted financially since the start of the pandemic. Ninety-three percent of nursing homes said that government funding has been extremely important during this pandemic, with PPE, testing and staffing being the top three contributors to increased costs.

Ninety percent of providers indicate that paying for PPE is a significant driver of costs. From gowns to surgical masks to gloves to N95 masks, providers must ensure there is adequate PPE for every staff member, much of which comes with inflated costs. But even months into our response to the pandemic, some nursing homes are still struggling to obtain adequate amounts of these essential supplies due to strains on the supply chain.

Nearly one-third of providers report that regular testing for residents and staff is a primary expenditure. Many states have mandated ongoing testing of staff and residents, but a lack of clarity remains as to who should pay for it, leaving some providers to pay for testing staff – and even some residents – from their own budgets. But testing is only as good as the speed of its results. With significant delays in lab processing, some have purchased their own point-of-site testing machines.

Seventy-eight percent of respondents say they’ve incurred substantial costs related to workforce needs. Nearly half of providers have hired additional staff or utilized staffing agencies to address this all-hands-on-deck situation. Frontline workers who put their lives on the line every day should be appropriately compensated for the sacrifices they have made since day one. Providers have increased hourly wages, and instituted hero pay and bonuses to incentivize workers.

Nursing homes cannot shoulder these costs alone. Providers were already operating on razor-thin margins before the pandemic hit due to chronic Medicaid underfunding. Now, 72 percent of providers say they will be unable to maintain operations for another year at the current rate.

Sadly, this scenario is already playing out. Reports from Rhode IslandMichigan and New Hampshire show that financial hardships due to COVID-19 have been too great to overcome, forcing some operators to make the painful decision to permanently close their doors. Even though 96 percent of nursing homes have received some government funding due to COVID, the same percentage of providers say that they will experience financial hardship when that funding runs out.

We have demonstrated that when long term care facilities have the necessary funding to get the equipment and supplies they need, positive outcomes can be achieved. Data shows that at the end of June, COVID-19 cases and deaths had dropped significantly since the beginning of March. But with a surge in cases nationwide and community spread, the progress we’ve made is in jeopardy. Last month, nursing homes began to see an uptick in cases due to community spread, which experts have demonstrated is the primary driver of infections in long term care facilities.

Complacency is our enemy. The virus is still a very real threat, and stopping it requires a continuous, collective effort. We need funding. We need testing and PPE. We need members of the public to wear masks. We need everyone doing everything they can – particularly the public health sector – to protect our most vulnerable citizens.

Federal and state governments must once again refocus their efforts on long term care. With the resources we’ve received thus far, we’ve been able to save thousands of lives. We can save even more if we can make our seniors and frontline caregivers a priority.

Mark Parkinson is the president and chief executive officer of the American Health Care Association and National Center for Assisted Living, and former governor of Kansas.

Originally published in The Hill.