Netsmart CareThreads
Netsmart CareThreads

Episode · 1 year ago

3. #seniorliving How to Survive and Thrive During COVID-19

ABOUT THIS EPISODE

2020 looked like a banner year for long-term care until COVID struck. Very soon, it became clear that our facilities not only would fail to escape the virus, but we would become ground zero for it.  

  

Consequently, we're experiencing a drop in census, an increase in the cost per resident, more and more burnt out staff, and a major reputational hit to our industry. In light of all this, where do we go from here? 

  

Mark Parkinson, president & CEO at American Health Care Association, joined this episode of NetSmart to talk about COVID's impact on our current business operations. 

  

What we discussed with Mark: 

  

- How to prepare for the next two years 

  

- Upcoming regulatory changes that could affect long-term care 

  

- The potential impacts of the 2020 elections on the industry 

  

If you want to hear more episodes like this one, look for the Netsmart CareThreads podcast on Apple Podcasts, Google Podcasts, Spotify or Stitcher.

Welcome to net smart care threads, apodcast were human services and post tocute leaders across the healthcarecontinuum come together to discuss industry trends, challenges andopportunities. Listen is we uncover real stories about how to innovate andimprove the quality of care to the communities we serve? Let's get intothe show I'd like to introduce our guest speakerof Mark Parkinson, and we are honored to have him here with US mark is thePresidencgo te Mericat health care, Assetian Wen, one of the largestassociations and lobbying groups in Washington, representing fourteenthousand skill nursing facilities at assisted living facilities. Mork has agreat background for this, having actually run his own facilities back inKansas and Missouri, and also so having served as a congressman senator insidethe state of candas and that eventually Lieutenant Governor and the governor ofthe state, and he brings that skill and that ability to work across the aisleto his job in Washingtonton. This has...

...been obviously the hardest year in thehistory of the sector. There's no debate about that, both from a clinicalpoint of view of trying to take care of the people in our buildings and thenfrom a business point of view of trying to keep ourselves alive. We can neverface anything like this, and you know I think the irony is that when we cameinto two thousand and twenty many people, especially on the skill nursingside to two thousand and twenty might be the best year that we will havefaced in twenty or so years, because we had succeeded with the implementationof PDPM, it looked like PDPM was working for our residents and for us, aour businesses and our goal compan to two thousand and twenty was let's holdon to PDPM. Well that all changed in early March late February, when welearned that this world wide pandemic not only was not going to spare in thelongterm care sector, but in reality we were going to become ground. Zero forthis pandemic were now about six months...

...into that. I think that this is about atwelve month event. On the clinical side. It's then going to take longer torecover T we're about halfway through the nightmare in our buildings. I thinkthat by March of two thousand and twenty one roughly six months from nowwill be in a much better position with a vaccine that I believe by then willia've been distributed to our frontline workers to our residents. I that lookslike it works for the elderly testing will be better etce. In fact, I thinkthat Reallya, the next six months, is going to be us sort of winning againstthe virus. The virus, as has beaten the country in the first six months, butfor the next six months. I think that every week there will be better news ontesting. I be better news on Maccines atter news on treatment and, ultimatelyI think we will end up with the vaccine,...

...but we still got a lot of work to doover the next six months. So we are proactively developing plans for twothousand and twenty one, an ideas we think we'll move the sector forward en.We certainly hope so so I know the last six months have been pural. The nextsix months are going to be hard. I think they'll be better than the lastsix and then the real story will be told and thefuture of the sector will be defined, and I remain optimistic that it will bebetter than what we've had in the past. I'm going to start with kind of ageneric question that I think ties many of your points together when we weretalking before you talked about how you talkd to fifteen or twenty the CEOS aday and the bigest focus on their mind is how do they financially survive thePendet? What's your take away from those converssations and what advice doyou have for people who are living through that? As as a former upritoryourself, it's very case by case, so...

...the pandemic has affected differentoperators in very different ways. If you were in the northeast and got hithard early on, the sense of figures that I gave are completely inapplicable.Those buildings didn't lose ten or twelve percent census. Some of thosegollings lost twenty three and forty percent sensus. On the other hand, ifyou're in the Midwest or on the West Coast or are fortunate onout or through you know,hard word haven'tg had a bunch of cobid cases. Your sensuse might only be downsix or seven percent for folks in the skilled nursing space because of thefederal funds that we've been able to receive people in that. Second category aredoing: okay, no, but nobody's doing great but they're doing okay, thepeople that are really at great risk are the folks that got hit super hardearly on and then the other people are folks that are independent, living, anassistant living that have gotten hit...

...hard. You know, maybe they were in thecovid hot spots, early on and they've gotten, absolutely no funding. So a bigpart of this continues to be federal. HEALP mean we've got to continue to getthe scream of money going. Tha and- and you know, Bein successful in the skillmercys side, we got work to do with the sist of living, but a big big situationhas to be federal. Help operationally. There's not a lot that you can donumber one thing. You Know Iu if you can keep coved low in your building anddevelop the confidence to reopen two admissions and then get your marketingregoing to the hospitals to er, whoever else ar you referral sources, that's an important thing to do and asownerisis his testing requirement is- and I believe me I'm getting emails intext from folks today that aren't happy about it. I think in the medium Ronit's going to prove to be a beneficial...

...thing. I think it's going to lowercovid in our buildings and I think it's going to increase the confidence of thepublic incoming into our buildings. So you know I focus on keeping covid lowreturning to your normal marketing watching your expenses, like a hawk allof the things, I don't have a silver ballet Kevin going down that path, anin some of our conversations. We talked about the infection rates and Al beinglower than an IIL, and your feeling was the fact was due to different staffinglevels and less physical contact with the patient. Potentially, what are thelearnings that some of the operators can take away from DC when we startdoing those retroespective studies that you just talked about, and you see thedifference in infection rates between the two? How ill those you know hat?Will the learnings be Tho, be promugated down to a skilled, nursing,fatility, potentially through new regulations, or is it something thatoperators can take to heart and start...

...for doing now to better improve theirmarketing as they moved forward great question? What you know what washappening to early on with this virus was that we had all these employees atin their communities. Some of them were getting covid. Some of those people were showing nosymptoms. They were coming into t back into the longterm care buildings andbecause we didn't know that a symptomatic people were spreading thevirus back in February and March that the perfect infection control wasn'tstopping it you, there was no requirement before covid that everytime you interact with a resident, you wear a mask, and so as we were dressingthem beating them transferring them, hugging them socializing with them. Eating with youknow, covid was getting spread, so it's not surprising that one of thefindings is that are eallyer on the more staff you had the higher chance.It was that you had covid just because...

...you had a higher chance of an a symptomatic employee, but we've learned some other lessonsthat I think can be utilized. I think one of the reasons that covid has beenlower and assisted living in an independent wiving. It's not just thestaffing levels. It's also the fact that ther are PRI, typically privaterooms, and so it's much easier to cohore and to quarantine and to protectsomebody in a situation where there's covid out there. I hope that, as we do theretrrospective on what's next and what we should do in the future, they'll bea real look at building nursing homes in the futurethat have more private raps. I think it's a shame that all of thesebuildings were built in the S A with these double room designs, and I don'teven understand you know why it happened. Stacy and we had tenbuildings and we built them all up. Fron the ground up and we had allprivate rooms, the dollar amount between a privateroom and a shirt room from a...

...construction and development point ofview. It's not as much as you might think, and so, hopefully, movingforward. You know, that's that's something that well look at is Wi'll,learn about the important or private rips. I think. We've also learned aboutthe importance of stok tiling PPE. You know which nobody was doing. I thinkcms is going to issue some kind of requirement that wek store up threemonths, an PPE we can't get it now, but in the long run that's a good idea,particularly if we get thim to find it so we're going Ta we're Goinna O storeup PP that we're going to need to do more, an infectioan control. You knowwe haven't fought that we've actually encouraged. The government cannotreduce requirements on infefection control and we're going to probably beadvocating for more infection, control and buildings in the future. So it'sbeen a horrible nightmarer and you know there's no way to put a positive spendon fifty thousand people tying in our...

...buildings, but there are some positivethings that can come out of that tiff and I think the most important thing isthat we that we look in the mirror that we don't just blame others. There are alot of others to Bli the public policy decisions that have been mad during thepandemic have been awful, just really bad, but I also think we have to lookat ourselves and say: Are there things that we can do to be better? And Ithink if we go in with that attitude, we can make thus power. So based on mytacpalations and some reading, I did there was been more than thirty. Fourhundred tovid related n lawsuits already get. Has Businesses? That'sthat's not justking living facilities across all businesses, you, it wassenior living biding at the center of the storm. Do you have any visibilityand, to you know one of those lawyers targeting and what can the people onthis call do to protect themselves as best as they can and has a big employerourselves? What should we be thinking about?...

It's absolutely critical that that weget this my ability of protection. Now, if we don't- and even if we do, I meanit's not complete immunity. What it does is, as it says that you can't besued for simple neglegoncs, there has to be gross nealigent or intentionalactivity. So it's not a it's, not a complete good out on jail car ND free!There's, still you know some things that have to be gone. It's likeanything else, really good operators that are doing the right thing, inddocumenting that they are doing the right thing and not saying dumb thingsand emails that you know end up getting used against them. We'll do okay and people that aren't doing the rightthing and thit end up sitting around dummy mals are going to be in trouble,and so I would absolutely be talking to my liability carrier asking thequestion that Kevin. Just asked what aure best practices I'd be talking tomy general counsel or whetever Youre apside lawyers, whatever it is. Whatshould we be doing in our buildings following all of the GUYAND aid? I knowit's hard because some of the guidence...

...is conflicted, anddeplicateve, etcetera,but doing everything that you can and documenting it to keep coin out of thebuildings and keep it from spreading once at thin and documenting I'mrepeating myself, but that's really really important. Those are the thingsthat I would be doing. I would be testing once a week all staff. I wouldbe doing that even before the rag, and I would definitely be doing it with thereg. Even if I was in a stateant, an a low, positive rat I'd be testing tatevery week. It will show that you gone above and beyond, and I also think it'sthe best way to keep covid out just knowing who's got it. WHO Doesn't? Iknow it's not perfect, because there's still six days in between each of thosetests, lat staff a go out in the community and get it, but I would betusting spaff once a week. You know you talked about when you were governor andyou had to lead for the the last financial meltdown and your budgets forWora and you're, managing with no revenue or decreasing ourevenue. Whatadvice would you have for the people on...

...the coll having done that at the statelevel dealingl, with the requirement have to balance the budget which mostof the people in the school have to do what we are learning from that processthat they could apply to their to their day today, businesses? Well it's hardduring the pandemic, but it's important that you double down onyour political activity. You no get together with your State Association,which everone that you belong to and say what are we doing to stave off amedicad cut in two thousand and twenty one Hel me the plan and I want to be apart of the plant and so really really active political involvement. Lobbyingefforts. It's the only way because the governors are going to be undertremendous pressure to cut a Gazilian thangs and we have to stand out is theone thing they shouldn't cut. Now. We've got some good policy argumentsfor that. The fight is still taking plice in our building. So it's not asmart policy thing to kin long term...

...care right now, ut, there's going to bepressures to cut everything, and so, if we're quiet and we're not at thisstatehouse, you know we're not lobbing in whichever way it'll occur like thismight all be virtual. But, however it occurs. We just really have to doubledown our loving efforts, or else you know the end t result is not going tobe good mark. From my point of view, I've got apage full of notes that I took from when you were speaking as usual. Itreally appreitiate. You know your time is your most valuable asset, and Iappreciate you Takeng the time to spend it with us and our clients on the call.So thank you very much. It was extremely education at Netsmart. We understand thechallenges facing provider organizations. Our team will help younavigate changing value, based care models with solutions and services thatmake person centered care or reality will equip you with technology andservices that provide holistic, real time. Views of Care Histories thatinform better decision they in and better outcomes visit us today atntstcom Netsmart serving you. So you...

...can serve others thanks for listeningto the net smart care, threads podcast through collaboration and conversation,we can work together to make healthcare more connected than ever before andbetter support than communities we serve to ensure you never miss anepisode. Please subscribe to the show in your favorite podcast player, if youuse apple podcast, we'd love for you to give us a quick rating for the show.Just have the number of stars that you think the podcast deserves until nexttime.

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