James M. Berklan

Now THAT’S a big carrot, long-term care fans.

The opening round in the federal government’s incentive pay program was a humdinger this week. Officials announced $330 million would be flowing into operator coffers because they had kept the COVID-19 wolves on the other side of the door better than their general-population neighbors had.

More than three-fourths of all eligible nursing homes kept their COVID-19 infection and death rates below those in their surrounding counties from August to September.

This is indeed good news. But the realist in me — probably in a lot of us — wonders if more than 10,000 nursing facilities will ever see any bonus money again. News of the one-third of a billion dollar bonanza just happened to come as COVID-19 rates were hitting record highs in many parts of the country.

That’s not good news for long-term care providers, of course. Researchers have shown that nursing homes are hardest hit in areas that have more coronavirus infections in the general population. 

However, this enticement from the Centers for Medicare & Medicaid Services isn’t being offered only to operators with perfect, COVID-free programs. No, they just need to maintain virus rates below those of their neighbors’. This is where frequent testing should come in especially handy, not to mention quick isolation efforts and separate, dedicated COVID-19 wings and floors. 

The senior care profession has learned a lot about dealing with this invisible monster, and now it’s time to put the lessons learned to work. 

Providers still have their work cut out for them. After all, while long-term care operators now may be more conscious of mitigation and safety strategies, they still can’t change the fact that they offer the perfect, deadly conditions for the coronavirus to thrive: elderly mostly frail people, with many comorbidities living close together. 

So the challenge is this: Stay ahead of the public at large even though you have a much more vulnerable population.

The first round of payouts addressed statistics through September. The next round will cover efforts into October, so providers might ride a little more good fortune for that. But then things could get tense.

One thing I’d like to see, and I know I’m not alone, is a breakdown of which facilities earned a bonus. (Officials initially released only a state-by-state breakdown.) This would help pinpoint where outbreaks occurred and assist further research into the role community spread plays, as well as where nursing home workers reside.

I’d also like to see some assurances that this incentive program isn’t punishing facilities that might need help the most. We could see a further widening of the gap between “have” and “have not” facilities if all we’re doing with this incentive policy is punishing providers that suffered an outbreak, for whatever reason.

Everyone should remember: Those who need a hand to rise typically aren’t going to get very far if they have a foot on their head.

Follow Executive Editor James M. Berklan @JimBerklan.