Nursing Homes Will Weather Coronavirus Crisis — But No Excuse For Lapses

March 15, 2020, Alex Spanko, Skilled Nursing News - Public health officials and the nation’s most prominent nursing home industry leaders haven’t minced words when describing the threat that COVID-19 presents to residents and operators, and neither will we: The next few months will present the some of the most serious challenges that long-term and post-acute care providers have ever faced.

The best nursing home operators are among the most dedicated professionals in any industry, and their herculean work over the coming weeks and months will ensure that the space will weather this crisis.  No other setting, no other people could provide the kind of care that nursing home residents need.

But there’s no room for unforced errors.  The industry has been warned in too many ways, in too stark language, to receive free passes on preventable problems.

Mark Parkinson, president and CEO of the American Health Care Association, said it best when he described the novel coronavirus as “almost a perfect killing machine” for the elderly. 

But the Centers for Medicare & Medicaid Services (CMS) was just as clear when issuing sweeping and unprecedented restrictions on nursing home visits, as were the scores of local health officials warning anyone without an essential reason to stay away from health facilities for the elderly.

The general public will forever associate the COVID-19 pandemic of 2020 with the nursing home in Kirkland, Wash. that served as the epicenter of the first major outbreak — and was directly linked to 25 deaths.

It’s far too early to tell what exactly happened in that isolated case, but if the daily updates of a rising death toll at a nursing home, on every news website and television screen, weren’t enough to convince other operators of the dangers, nothing is.

Part of what makes the coronavirus crisis so unsettling is how relatively little we know about it; unlike the familiar flu, top scientists and doctors are still learning how COVID-19 behaves.

Key pieces of information, such as its exact mortality rate, remain works in progress, though preliminary reports show the profound risk that nursing home residents face: Based on data from China, the Centers for Disease Control and Prevention (CDC) estimates that nearly 15% of people aged 80 and older who contract COVID-19 will die, but Parkinson implied that the real number could be even higher for the 84-and-older population that makes up the average nursing facility.

For that reason, the federal government and individual operators are completely justified in barring all non-emergency visits to nursing facilities.  Younger, healthy people can spread the disease without ever realizing they have it, according to health officials, and the risk is too great.

But perhaps the most troubling anecdotal reports I’ve seen since the start of the coronavirus crisis come from people with loved ones in nursing homes who distrust the operators, and do not understand why they cannot visit their mothers and fathers.

At this crucial moment, operators need to be open and honest with the public about why these bans are in place.  They should not be afraid to put it in blunt terms: We are doing these things to prevent a significant number of deaths that will likely result if the coronavirus spreads to this facility. 

We know that you may have had a bad experience with a nursing home before, or you are skeptical of the industry as a whole.  But you need to trust the doctors and officials who are telling you that these lockdowns are necessary to protect the health of our most vulnerable residents — and the public as a whole.

So if there are any family members of residents in nursing homes who are reading this, please listen to the experts and stay away, even if you don’t think you feel sick.  Call your loved ones every day, set up regular times to video chat, text for hours — do everything you can to stay in contact, but keep that contact distant.  Operators aren’t trying to hide your relatives from you; they’re trying to keep an incredibly fatal virus at bay.

For the rest of us, it’s important to accept that our lives will temporarily change in ways that, as Americans, most of us have simply never had to face before.  We’ve already seen it in the mass cancellations of sporting events and conferences, in the strikingly bare shelves at many supermarkets across the country, and in the empty downtowns of major American cities.

It’s perfectly normal to feel unmoored — I’m personally disappointed that my beloved New York Mets, normally a pleasant source of distraction during troubled times, won’t be taking the field on March 26 as scheduled.  Spring isn’t going to be the same without baseball and other major public gatherings, but all of these efforts are to ensure that our most vulnerable citizens stay safe.

At Aging Media Network, SNN’s parent company, we’re doing our part: We postponed two events that we’d planned for March, suspended all work-related travel, and implemented a mandatory work-from-home policy.  We also pledge to keep bringing you the most important information about the rapidly evolving situation, delivered right to your inbox each morning.

Maybe you’re reading this at home right now, and maybe you’ve had to cancel a cruise or a large family gathering — or had to explain to a disappointed child why they can’t attend that basketball game they’ve been looking forward to for weeks.

But every time you voluntarily heed a public health warning, you’re protecting someone who doesn’t have that luxury — the nurse working long hours in a SNF, the otherwise healthy young woman with a compromised immune system restocking the shelves at your local grocery store, the 87-year-old grandfather recovering from surgery at a rehabilitation center.

Waiting a few more weeks for Opening Day, or the next night out at a crowded concert, is a trivial price to pay to save the lives of untold numbers of Americans.

So as nursing home operators stare down the tough weeks ahead, remember that the people who work in this industry have the power, the compassion, and the dedication to keep our nation’s most vulnerable people as safe as possible.

They may even soon be called on to provide backup for overburdened hospitals should the number of COVID-19 cases continue to rise, as made clear by CMS administrator Seema Verma.

“Our actions allow hospitals to reserve beds for the most severely ill patients by discharging those who are less severely ill to skilled nursing facilities,” Verma said late last week in explaining some of the emergency steps the federal government has taken thus far, including the suspension of the three-day stay rule for Medicare SNF coverage.

But the consequences for any preventable lapses will be severe, and providers have will have no excuse when the government and media scrutiny eventually comes.  The warnings have simply been too loud.