The COVID-19 pandemic has turned the long-term care industry on its head after causing the death of 3,856 residents — more than half of the total number of deaths statewide, according to the state Department of Public Health figures. It’s unlikely that nursing homes will be the same.
Here are five changes that are likely here to stay.
1. Lower occupancy, more competition, better care
On average, nursing home occupancy declined 15 percent across Connecticut from January to September 2020, according to data reported by the state. That decline does not come from deaths alone.
“Consumers confidence in the model of care and increased competition from home care and community-based options are driving occupancy down,” said Matt Barrett, the president and CEO of the Connecticut Association of Healthcare Facilities.
Between increased competition and the reduced number of residents, more nursing homes are likely to continue offering private rooms, something hard to find pre-pandemic.
“Currently as much as 20 percent of nursing home beds are unfilled because patients are required to be in private rooms. These requirements will go away, but will consumers want to go back is the question,” Barrett said.
Not only do private rooms aid in the prevention of spreading infectious diseases, but they also allow for higher quality of care and a “more dignified nursing home experience,” Barrett said.
That’s an experience that many residents and families will likely be pushing for, in the years to come.
2. Technology for family connection
Since March, visits by family and friends have been severly limited at most nursing homes and assisted living facilities. Visits have been outdoors, less often, for less time, and only after a negative COVID-19 test.
In place of regular visitation, technology has come to play an essential role in keeping loved ones connected. Smart phones, iPads and other devices are now offered as a standard course of treatment.
“Nursing homes had to move to a much greater use of technology to facilitate visitation,” Barrett said. “The widescale use in nursing homes today was accelerated as a matter of necessity. Now we know technology can be used as part of the quality-of-care formula.”
The technology has been around for more than a decade, said Barrett, but its use by care providers was limited.
“One thing that the pandemic and severe visitor restrictions showed us very clearly is that severely restricting visitation has an emotional and psycho-social impact on residents and does contribute to the deterioration of their health,” Barrett said.
3. Technology for medical appointments too
Technology to connect residents with doctors and other healthcare providers is likely to stick around too.
Instead of waiting for a physician to visit a nursing home or needing to travel from a facility to a doctor’s office, in many cases telehealth will continue to be used to connect residents with more timely care.
4. A push for a higher paid workforce
For years prior to the pandemic, there was concern in the industry about recruiting and retaining nursing home staff — about how to improve the pay and status of the profession, and to recruit staff who will want to say in the field.
But little progress was made toward these goals.
“The pandemic revealed some longstanding issues that have been present in the care delivery system for a long time,” Barrett said. “It really comes down to the fact that these tend to be lower-paid employees in our economic system.”
Nursing assistants and resident aids are typically paid close to minimum wage and turnover is frequently high.
“Staffing went to crisis levels during the pandemic and as we move to the other side this is going to be one of the major challenges,” Barrett said.
As most nursing homes are largely funded through Medicaid and Medicare, Barrett said that increasing the minimum wages was not a sufficient solution. To prevent a reoccurrence, and to address longstanding issues, Barrett and other industry advocates are lobbying for a substantial additional investments from state and federal government.
“This legislative session we are pushing for hundreds of millions in new resources that are going to be needed,” he said.
As the state with the sixth oldest population in the country, these problems will remain an issue.
“A workforce to take care of this population is a major issue,” Barrett said.
5. Reporting and testing?
For families of nursing home residents — or potential residents – readily available data about the spread of disease in each facility statewide has changed how families select a care facility.
“Families look at the weekly reports from the state with cases and deaths when choosing a home,” said Mairaid Painter, the state ombudsman of long-term care.
Although data regarding flu cases and occupancy was collected in the past, along with routine inspections, it was never previously at the fingertips of families when choosing a facility.
Whether or not this same level of information availability will continue post-pandemic is unclear, however. As of now the Department of Public Health has not confirmed if and when the reporting would end.