Long-term Care

Information about the impact of COVID-19 on the long-term care, skilled nursing, assisted living, and home health care workforce.

(09/09/21) CMS to Require COVID-19 Vaccinations for Workers in ‘Most Health Care Settings’ – Including Home Health Care
New guidance from the Centers for Medicare & Medicaid Services will require COVID-19 vaccination for workers in most settings that receive Medicare or Medicaid reimbursement, including home health care settings.

(08/19/21) Pandemic, Labor Shortages Have Left Long-term Care Facilities Competing for Staff
Nursing home advocates say that the COVID-19 pandemic with a general labor shortage and vaccine mandate is making it more difficult to keep staff. The Biden administration announced that it will require nursing home staff be vaccinated against COVID-19 as a condition for those facilities to receive federal funding. Advocates say the decision will lead to more staff shortages, as “many providers struggle to recruit and retain caregivers who can often find less demanding jobs in other settings, such as hospitals and industries that can offer better pay.”

(08/18/21) US to Require Nursing Home Employees to Get COVID-19 Shots
President Joe Biden and his administration has announced that it will require nursing home employees to receive the COVID-19 vaccination as a condition of employment at health facilities participating in Medicare and Medicaid programs. This announcement has come as the delta variant continues to spread and the vaccination rates among health care workers in nursing homes remains stagnant.

(08/10/21) Direct Care Workforce Shortages Have Worsened in Many States During the Pandemic, Hampering Providers of Home and Community-based Services
This article from the Kaiser Family Foundation highlights preliminary findings from their new study. This new study focuses on state policies that were implemented during the pandemic and the pandemic’s impact on Medicaid HCBS enrollees and providers. The study has found that most states are experiencing worsened direct care worker shortages amid the COVID-19 pandemic.

(08/02/21) Nursing Home Advocates Shift Stance on Mandatory COVID-19 Vaccinations for Staff
The latest COVID-19 pandemic surge caused by the COVID-19 delta variant has resulted in several long-term care providers and advocates to strongly suggest vaccination mandates for staff. Long-term care facilities were initially prioritized for COVID-19 vaccination, but vaccination rates among staff are much lower than vaccination rates among residents.

(08/02/21) Once Common, COVID-19 Deaths in Long-term Care Were Rare Across Most States in June
A new analysis from Kaiser Family Foundation expounds on a previous data note from April 2021 which has shown a significant decrease in weekly deaths and cases in long-term care facilities. The previous data note attributes these record lows to high vaccination rates among long-term care facility residents and staff. The current analysis examines trends in COVID-19 cases and deaths through June 2021. The new analysis finds that fourteen states have reported zero or close to zero weekly deaths, 5 states have reported an increase in deaths, and most states have reported higher deaths rates outside of long-term care facilities.

(08/02/21) COVID-19 Cases and Deaths in Long-term Care Facilities through June 2021
A new analysis from Kaiser Family Foundation finds that COVID-19 deaths in long-term care facilities across the nation have significantly declined since the COVID-19 pandemic began. Thirteen states and the District of Columbia have reported no deaths and most other states have reported average weekly deaths in long-term care facilities at or near their lowest levels.

(07/28/21) California Mandates COVID-19 Vaccination for Long-term Care Workers
California Governor, Gavin Newsom, has released a COVID-19 vaccination mandate for long-term care workers and workers in other health care settings. Long-term care workers will be required to get vaccinated or participate in weekly COVID-19 testing. The mandate will take effect on August 9, 2021, and healthcare facilities will have until August 23, 2021 to become fully compliant.

(07/14/21) Larger Nursing Home Staff Size Linked to Higher Number of COVID-19 Cases in 2020
A new study published in Health Affairs finds larger staffing sizes at nursing homes were linked to higher numbers of COVID-19 cases within those facilities in 2020, even after facility sizes were taken into account.

(06/25/21) New York Nursing Homes Still Subject to COVID-19 Restrictions
Although New York State has lifted much of the regulations regarding COVID-19, nursing homes are still experiencing significant restrictions in visitation and social distancing requirements. This is in part being blamed for staffing shortages, high turnover, and financial issues.

(06/23/21) COVID-19 Cases Up in State Long-term Care Centers, Data Shows
This news report from WESH discusses the recent rise in COVID-19 cases in Florida’s state operated long-term care facilities. The facilities credit bonuses offered to workers to vaccinate as preventing further harm, as cases and deaths have been on the rise among staff and patients over the previous 4 weeks.

(06/21/21) Will COVID-19 Improve Long Term Care?
In this opinion piece published in Forbes, a former professor from the Harvard School of Public Health and Harvard Medical School discusses ways in which the COVID-19 pandemic may improve or change long-term care going forward. Politicians are also bringing increased attention to long-term care through funding proposals and speeches on the matter.

(06/20/21) Nursing Facilities Look at Pandemic-wrought Change
The COVID-19 pandemic brought new and exacerbated existing challenges to the long-term care industry, including issues with cost of care, turnover and labor shortages, and working with the state to better optimize staff and patient placement.

(06/16/21) How Do CMS’s New COVID-19 Vaccine Reporting and Education Rules Apply To Different Long-Term Care Settings?
In an effort to clarify the new rules on vaccine reporting from the Centers for Medicare & Medicaid Services, the Kaiser Family Foundation published this issue brief. There are different requirements for both education and reporting depending on the type of long-term facility.

(06/11/21) HHS Issues New Reporting Requirements, Deadlines for Provider Relief Fund Recipients
Financial assistance provided for home health providers from the CARES Act Provider Relief Fund will now require new reporting requirements. The US DHHS has included some clarifications and explanations on what is required for this reporting response from providers.

(06/09/21) Opportunities in a Time of Crisis: Launching Innovative Long-term Care Programs During COVID-19
In this commentary published by United Hospital Fund, the author advocates for using telehealth in innovative ways in long-term care settings. The long-term care industry has experienced high rates of turnover, shortages in workers, and other challenges since prior to the COVID-19 pandemic, and telehealth may offer solutions to improve outcomes for both patients and providers.

(06/01/21) Engaging Nursing Assistants to Enhance Receptivity to the Coronavirus Disease 2019 Vaccine
Long-term care facilities were disproportionately affected by the COVID-19 pandemic which resulted in this sector being called the most dangerous job in the nation. Certified Nursing Assistants (CNAs) practicing in long-term care settings provide most of the direct care to residents and represent the largest proportion of nursing home personnel. Despite their role in long-term care, several studies have found that more than half of CNAs reported that they were unwilling to receive the COVID-19 vaccination until a future point in time. This article from The Journal of Post-Acute and Long-Term Care Medicine discusses the importance of understanding and mitigating vaccine hesitancy among CNAs.

(06/01/21) Despite Vaccines, Nursing Homes Still Struggle With COVID Outbreaks, Deaths
This NBC News article covers the impact of vaccine hesitancy on nursing homes, where unvaccinated staff are being blamed for outbreaks of COVID-19 that force shutdowns of facilities and contribute to deaths and illness among staff and patients. Although nursing homes were an early and important focus for vaccination, the constant inflow of new patients means these facilities remain high risk.

(05/27/21) Nursing Home Staffing Levels Did Not Change Significantly During COVID-19
New research published in the journal Health Affairs has found nursing home staffing levels were not significantly different during the COVID-19 pandemic when compared to the same period prior to the pandemic. The study did find small increases in staff hours in counties with high COVID-19 prevalence.

(05/25/21) Broadened Scope of Practice in Assisted Living Should Continue After Pandemic, Association Argues
The Governor of Massachusetts, Charlie Baker, has lifted several COVID-19 restrictions and announced that the state of emergency would end on June 15, 2021. This announcement has caused much concern among assisted living facilities as the state of emergency permitted the state to waive regulations that define the scope of practice for several health professionals. Since this announcement, the Massachusetts Assisted Living Association has advocated for permanent expansion of the scope of practice for assisted living facility nurses.

(05/11/21) CMS Expanding Efforts to Grow COVID-19 Vaccine Confidence and Uptake Amongst Nation’s Most Vulnerable
The Centers for Medicare & Medicaid Services announced a new regulation requiring long-term care facilities and intermediate care facilities for individuals with intellectual disabilities to release information on the vaccination status of both providers and patients, beginning June 14, 2021.

(05/02/21) Nearly 40% of State’s Nursing Home Workers Declined COVID-19 Shots
New York State is seeing a slowing vaccination rate among its nursing home workers as nearly 40% of the 146,000 workers statewide have not yet been vaccinated. This is particularly concerning as nursing home residents have been disproportionately impacted by the COVID-19 pandemic. Although facilities with extremely low staff vaccination rates are escalating the concerns of resident relatives and health professionals, Governor Cuomo does not believe this is cause for vaccination mandates. Facilities with high vaccination rates among staff have shared their strategies for addressing vaccine hesitancy so that other facilities could implement similar approaches.

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