Hospitals across the United States are taking emergency measures to make beds for people with COVID-19. The result may be the proliferation of patients throughout the continuous process of healthcare. Therefore, driving patients into helpful residential communities and may disrupt their business model in a lasting manner.
The future scenario is that to create the COVID-19 capability, the hospital will send individual patients to skilled nursing facilities. To adapt to the influx of hospital patients, SNF will transfer some people to other environments, such as assisted living. Those moved will probably be the long-term care residents with the least medical needs.
Although this situation has not been shown dramatically, there are reports that it is happening. In some places, especially New York, precipitation conditions are rapidly forming. Last week, the authorities there issued an order requiring nursing homes to accept in patients who are “medically stable” regardless of their COVID-19 status.
States should adopt a more targeted approach to deal with the surge in demand, rather than such a “one size fits all” directive. Meanwhile, some senior life service providers across the country are already negotiating patient issues with hospitals, health systems, and insurance companies to find new payment channels to support these efforts. Primarily through Medicaid and Medicare Advantage.
Ability to Assist Life, Ability to Care
As the COVID-19 epidemic worsens nationwide, it is undeniable that the demand for additional hospitals is undeniable. Witnessing the situation in New York City, where a field hospital is over Central Park, the Navy has just A medical ship docked near Manhattan.
Anne Tumlinson, Founder and CEO of ATI Advisory – a health care and aging consulting firm – said that post-acute care and the elderly community clearly could play a role in freeing up hospital capacity.
She told SHN that the most obvious is that hospitals should seek long-term emergency hospitals and inpatient rehabilitation facilities because these environments are closest to emergency hospitals and can accommodate more medically intensive patients. Skilled nursing facilities closely follow that, and as the situation in New York suggests, SNF has been used to manage first aid capabilities.
Tomlinson is not yet clear about the role of assisted living, but she does think they will participate.
Indeed, the COVID-19 pandemic occurred when the occupancy rate in many assisted living communities was low. Due mainly to oversupply in specific markets across the country, the occupancy rate of assisted living nationwide reached a historic low last year before it began to pick up. According to data from the National Senior Housing and Care Investment Center, as of the fourth quarter of 2019, the average occupancy rate for assisted living nationwide was 85.7%.
Gleckman also believes that, as he described in the Forbes column last week and later in an interview with the SHN, a desirable living community takes people away from skilled nursing facilities. He also pointed out that in many assisted living communities. There is excess capacity. In fact, due to COVID-19, the occupancy rate may decline further.
Although assisted living is a demand-based product, it is almost entirely a private payment industry. Therefore, Blackman said that because of the stock market crash in recent weeks and the rising unemployment rate, the elderly may delay moving because they cannot afford it, or the adult children may now be unemployed and unable to pay wages. That seems reasonable.
Operators who provided skilled care and assisted living are naturally in an excellent position to help manage the flow of patients throughout the continuous process.
Currently, Vivage does have patient-accommodating beds in its SNF and is discussing renting these beds to hospitals. The current Vivage policy is to deny admission to any patients with respiratory diseases unless their COVID-19 test is negative. However, Bernstein believes that this policy, as well as the situation on how WellAge and Vivage work with these hospitals in order to manage surges in patients, is volatile.
Keystone Kops Situation
Although the reasons for assisting the establishment of hospital emergency service capacity through assisted living are reasonable, the main obstacles must first be overcome. Perhaps most fundamentally, there is no clear and coordinated strategy for how to involve skilled nursing staff and senior living providers in the effort to manage the country’s healthcare resources and maintain the most vital hospital capacity.
Tumlinson herself is developing such a framework, but for now, she recommends that life support providers consult their skilled nursing facilities in the market to evaluate the information they hear from the hospital and identify potential areas for coordination. Most skilled nursing facilities are worried about patients who are arriving in the coming months and are starting to talk to other providers who may provide support.
Payment Opportunities and Issues
In addition to the general lack of coordination and guidance from federal and state agencies, if you want to accept the assisted life of patients from SNF, payment is another major crux.
For any business, payment is, of course, a crucial issue, but considering that senior life providers have faced rising COVID-19 fees related to labor and supplies. When they start to provide these fees, these fees are destined. This is especially urgent. Take care of COVID-19 patients.
Most long-term residents of nursing homes can reimburse nursing homes through Medicaid, but residents pay almost all paid life. Some states do provide exemptions so that recipients can receive Medicaid, but the profit margin is low, and the process of obtaining these exemptions can be burdensome.
In addition to Medicaid, there is another potential payment mechanism: Medicare Advantage.
If Medicare Advantage beneficiaries are transferred from the hospital to SNF or assisted living, it is usually necessary to pre-authorize and change the services covered. But like CMS, private insurance companies that provide MA plans have been abandoning the usual rulebooks.
In other words, in the face of a pandemic, senior life service providers should adequately focus on protecting their residents and staff. Still, at the moment, they are advised to better connect with the broader healthcare community in their market. Despite urgent concerns about issues ranging from infection control to cash flow, if providers can go beyond the business bubble, they can reap the rewards.
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