Limited personal protective equipment for long-term care providers poses a major risk to vulnerable patient-base

The New Normal

COVID-19 and Post-Acute Care

Limited personal protective equipment for long-term care providers poses a major risk to vulnerable patient-base

While hospitals were at the center of the initial wave

of supply needs for the U.S. healthcare system, survey results released mid-April by Premier Inc. indicated that the U.S. supply chain was facing a second wave, and second front, in combatting COVID-10.

Senior nursing and assisted living facilities have limited personal protective equipment (PPE) to care for a greater volume of patients, according to a Premier Inc. survey. This indicates a second critical wave of supply shortages, according to Premier, as hospitals move to reserve beds for severe COVID-19 cases and post-acute settings see an influx of patients. “While senior nursing

and assisted living facilities can serve as excellent sites for less critical cases, such moves cannot overlook supply and resourcing demands,” Premier’s survey suggests.

Premier’s survey of nearly 2,500 skilled nursing and assisted living facilities found that at the time of the survey, 24% of facilities did not have N95 masks on hand, and the majority of respondents had fewer than two weeks’ supply of surgical masks, isolation gowns and face shields. Other key products for which they had supply concerns included thermometers, exam gloves, alcohol pads, soap/detergent and hand sanitizer. Ninety-six percent were implementing PPE conservation strategies.

The New Normal

“In this next phase of the outbreak, states and healthcare providers are contemplating how they can best provide care for patients who need medical attention but are not critical care status,” said John P. Sganga, senior vice president of Alternate Site Programs at Premier. “Senior nursing and assisted living facilities can provide quality care for these patients, but this shift will increase their resource and supply needs, from PPE and tests to staffing. We already know that active cases of COVID-19 create surge demand of up to 17x for hospitals’ supplies, and our survey shows that nearly half of these post-acute facilities are already dealing with staffing challenges and that PPE remains elusive. Premier’s e-Commerce marketplace, stockd, has created a repository of conservation guidance and alternative production methodologies for key PPE, and we continue to collaborate on other solutions to help providers through this unprecedented period.”

Seventy percent of senior nursing and assisted living facilities in Premier’s survey said they were not fully prepared to treat an increasing number of COVID-19 cases as the virus surges. Furthermore, 48% of respondents say they are experiencing challenges with staff attendance as a result of COVID-19.

Premier said states were approaching capacity planning in nursing homes differently, as determined by hotspots. “New York, for example, ordered all nursing facilities to accept hospital discharges, including patients who have tested positive for COVID-19, while Massachusetts is beginning to empty nursing facilities to become dedicated sites for coronavirus treatment,” according to a Premier blog.

“States and providers must think strategically about how they admit patients from hospitals or move patients across alternate care sites, particularly since senior citizens are a population already vulnerable to COVID-19,” Sganga said.

Why long-term care providers in particular are facing an incredible challenge in COVID-19.

When asked to describe how COVID-19 is affecting the longterm care market, Bob Miller was blunt: “Very severely.” Indeed, the close proximity that the residents are in makes it very difficult to control, said Miller, executive vice president sales/vendor relations, Gericare Medical Supply.

Miller discussed this challenge and others to Repertoire. The following were some of his insights:

COVID-19 is a danger to resi

dents, and caretakers. “Really it’s twofold, you have the residents and you have the brave employees,” said Miller. “The nursing homes are doing an amazing job under the circumstances. You have the employees serving as caretakers and confidants. They are not only taking care of residents, but serving as part-time psychologists in making them feel safe, keeping their spirits up, and communicating with their loved ones.”

Getting long-term care providers the PPE products they need is a huge challenge based on their needs.

It changes quickly from day to day based on what is occurring in the nursing home, said Miller. “One day it could be gloves, the next gowns, then masks.”

Isolating those that have the virus in separate wings of the nursing home is a big test.

“The discipline it takes, changing multiple times of the gowns, mask, and gloves is something that must be done every time,” said Miller.

Overall, it’s a very challenging time for the long-term care industry, Miller said. “They are meeting the challenge with extreme vigilance.”