Long-term Care

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

(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.

(04/22/21) COVID-19 Long-term Care Deaths and Cases Are at an All-Time Low, Though a Rise In LTC Cases in a Few States May Be Cause for Concern
This analysis conducted by the Kaiser Family Foundation found that long-term care COVID-19 cases and mortality rates have significantly decreased since the COVID-19 vaccination roll-out. This study assessed state reported long term care facility data from 41 states and Washington D.C. to evaluate the trends in new COVID-19 cases and deaths since December 21, 2020. Of the states that KFF could statistically evaluate COVID-19 death rates, 21 states reported an all-time low and five states reported zero deaths. The analysis also found that COVID-19 death rates of all states in the analysis have declined by 89% since the start of vaccinations in December.

(04/22/21) Not Enough CNY Nursing Home Workers Get COVID-19 Shots; ‘We Are in a Race Against Time’
The New York State Health Department has reported that approximately 40% of nursing home workers in Central New York did not receive a COVID-19 vaccination. The state’s nursing home facilities have vaccinated approximately 87% of its patients but the low vaccination rates among staff is becoming a huge concern. Public health officials are worried that unvaccinated workers can trigger another COVID-19 outbreak in these facilities which has been reported in other states. The state has taken measures to increase the vaccination rates of nursing home staff but remains hesitant to push for vaccination mandates as this action may affect the supply of nursing home workers.

(04/15/21) Physicians Propose New Way to Manage a COVID Outbreak in Long-term Care Settings
This article from McKnight’s Long-Term Care News highlights a clinical research study conducted by doctors at the University of Chicago and the MGH Institute of Health Professions in Boston. The study assessed the clinical outcomes of high-risk COVID-19 patients in a 200-bed skilled nursing facility in Chicago. The researchers implemented an enhanced clinical management strategy that reduced the mortality rate of the facility by 16%. These findings suggest that other long-term care providers should adopt this model of care to better manage COVID-19 outbreaks in long-term care facilities.

(04/14/21) One Change That Could Help Nursing Homes Recover From COVID-19 Fears and Become Safer Places for Aging Parents
This opinion piece discusses the disproportionate effects of the COVID-19 pandemic on nursing home facilities. Nursing home residents accounted for nearly one third of COVID-19 deaths as facilities struggled to maintain staffing expectations. The federal minimum staffing requirements for nursing homes continues to be affected by a low supply of nursing home workers, high turnover rates, and low wages. The article suggests that increasing the wages for nursing home staff would subsequently increase the supply of nursing home workers.

(04/05/21) Should Health Care Workers Be Required to Get Coronavirus Shots? Companies Grapple With Mandates
Silverado, a long-term care company with several locations across the country, is one of the first facilities to require their staff to at least be scheduled to receive a COVID-19 vaccination. Several health care companies are debating the need to mandate COVID-19 vaccinations among their workers. A recent poll conducted by Washington Post and Kaiser Family Foundation found that most health care workers would support such a mandate. However, those that did not plan on receiving a COVID-19 vaccination would rather leave their jobs than be forced to get vaccinated.

(03/31/21) Federal Program to Bring Vaccine to Nursing Homes Missed Around Half of Staff
This article from NPR covers the issue of vaccine hesitancy and refusal in nursing homes. Across the United States, staff at long-term care facilities are refusing to be vaccinated for COVID-19, concerning health experts due to the outsized number of deaths and severe illness among long-term care residents from COVID-19.

(03/30/21) March 30 Web Event: Unsung Heroes: The Crucial Role – and Tenuous Circumstances – of Home Care Workers During the Pandemic
An interactive web event held by Kaiser Health News and The John A. Hartford Foundation assessed the critical roles of home care workers during the COVID-19 pandemic as well as the economic challenges of the industry for both providers and patients. Elisabeth Rosenthal, Kaiser Health News’ Editor-in-Chief, moderated the event. The panelists included Joanne Taylor, Owner of Senior Helpers Westchester, Clare McHugh, home health care client and novelist, Karen Gilmore, home care worker for McHugh, and Robert Espinoza, Vice President of Policy at PHI.

(03/23/21) New Studies Show Dire State Of Nursing Homes Even Before The Pandemic
Patients living in nursing homes and long-term care facilities make up less than 1% of the population but accounted for nearly two thirds of all COVID-19 deaths. This article highlights two studies that assessed staffing and nursing home spending prior to the COVID-19 pandemic that affected the emergency preparedness of these facilities.

(03/23/21) Assisted Living Center Company Requiring Employees to be Vaccinated by May 1
Civitas Living Center is a senior living facility with over 2,600 employees across multiple locations. The company is also a certified COVID-19 vaccination site and is now requiring that their employees receive the COVID-19 vaccine by May 1, 2021.

(03/11/21) COVID-19 Mortality Rates Among Nursing Home Residents Declined From March To November 2020
A Health Affairs analysis finds that COVID-19 deaths among nursing home residents declined by approximately 9.7% from March 2020 to November 2020. The reasons for a reduction in the mortality rates among this group are unclear, however, the study speculates that the increased use of PPE and improved clinical management may have contributed to this trend.

(03/10/21) Federal Health Officials Encourage Nursing Homes to Resume Allowing Indoor Visits
Health officials have encouraged indoor visitation in long-term care facilities as vaccination rates rise and COVID-19 cases decline among nursing home residents. The Center for Medicare and Medicaid Services has released guidance for nursing homes to safely resume indoor visitation.

(03/08/21) Long-term Care Providers, Experts Debate Legality of Vaccine Mandates
Ethical and legal concerns are at the forefront of a debate to mandate COVID-19 vaccinations for employees of long-term care facilities. Some experts believe that a federal mandate is necessary for the protection of facility residents. Atria Senior Living Facility and Juniper Communities have already taken the initiative to mandate vaccinations for their staff. Mark Parkinson, President and CEO of the American Health Care Association, hopes that increased vaccination rates among long-term care staff will eradicate the need to mandate COVID-19 vaccination.

(03/07/21) Industry Lobbying Left Nursing Homes Vulnerable in Pandemic
Prior to the COVID-19 pandemic, several nursing homes and long-term care facilities faced critical workforce shortages that affected the quality of care for its residents. The COVID-19 pandemic has elucidated both new and existing workforce concerns for the long-term care industry. As congress pushes for legislation that enforces staffing level mandates, lobbyists believe that staffing mandates may make matters worse.

(03/04/21) Some Rochester Long-Term Care Workers Hesitant to Receive COVID-19 Vaccine
Rochester Assemblymen, Harry Bronson, co-sponsored new legislation that relaxes visitation rules for nursing homes as the Department of Health reports high vaccination rates among residents of long-term care facilities. This decision raises concerns since only 50% of long-term care staff have received the COVID-19 vaccine. Although the CDC has recommended that all employees of long-term care receive the vaccine, there is still a high rate of vaccine hesitancy among long-term care workers.

(03/04/21) Reopening of Long-Term Care Facilities Is ‘an Absolute Necessity for Our Well-Being’
Long-term care facility residents and medical directors are urging federal and state health authorities to reassess visitation restrictions for long-term care institutions. Many of these precautionary restrictions were in effect since September. Some public health officials believe that the roll-out of the COVID-19 vaccination and the resulting decline in COVID-19 cases in long-term care facilities calls for a plan to safely expand visitation rules.

(03/03/21) Los Angeles County Finds Fewer Cases Among Health Care Workers as More Get Vaccinated
Los Angeles county health officials report that new COVID-19 cases among health care workers have significantly declined due to high vaccination rates among this group. Nursing home and long-term facility care workers have seen the largest decrease in new cases as they accounted for one quarter of all COVID-19 cases in the county. A nationwide Kaiser Family Foundation analysis conducted between February 15 and February 23, found that Los Angeles county is leading in the race to achieve a fully vaccinated health workforce.

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