James M. Berklan

It’s amazing how perspectives can change over time. We all think we know, and have known, what life with COVID has been like after all these months.

A cursory look at shifting attitudes and observations, however, paint quite a different story. It’s not as if anyone’s at fault here. It’s just that time can play tricks on a memory, as it’s so eloquently put by a favored singer of mine.

It’s easy to forget, for example, that a year ago we knew COVID-19 infections were at their highest rate to date and they were killing thousands of nursing home residents weekly. That has changed.

Also, back then, nearly half (44%) of providers in the McKnight’s Outlook 2021 survey said having enough PPE was one of their biggest worries, the third most popular choice.

In this year’s Outlook 2022 survey, the PPE concern had dropped by more than 90%, to just 4%. In addition, one-eighth as many listed having enough test materials as one of their biggest problems.

Times indeed changed. 

Certainly everyone is unanimous that staffing is the top worry, right? Last year, however, 12% didn’t think so. (This year? Only 2% don’t, meaning 98% do.)

Another example is job satisfaction. Always stressed, skilled nursing survey respondents averaged 5.9% (on a scale of 1 to 10) in job satisfaction this year. Last year, the average score was 6.8% — 15% higher, relatively speaking.

Long-term care workers know how to take a punch and keep on fighting, but that doesn’t mean they have to like it.

Do you really have a choice anyway?

Not if you want to stay in business. Although census was identified as a “top four” worry by far fewer respondents this year (62% vs. 82% a year ago), fears about compliance and policy matters multiplied, up to 55%, behind only staffing and census worries.

There is clearly still plenty of angst to go around. 

Perhaps it’s the resolve of longtime long-term care workers that keeps everything afloat. 

Just six months ago in another McKnight’s survey, 41% of respondents figured they would be back to pre-pandemic census levels by now. Instead, the number is just 15% in the latest poll.

In addition, last summer, only 14% thought census would take until 2023 or 2024 to return to pre-pandemic levels. By last month, that number had nearly quadrupled to 53%. 

Similarly, forecasts for a return to all “normal” activities reflected a more optimistic bent last year at this time. That was when some 77% thought activities would be back to normal by this point. Another 20% predicted sometime in 2022. It reflected a more hopeful time.

In reality, only 26% said they got there by the end of 2021. Another 38% expect to resume “normal” activities by the end of 2022. That’s 97% vs. a revised, hopeful 64%.

What’s been the difference? In a word, variants. 

The 2021 outlook survey was taken before either the deadly delta or wildly more transmissible omicron strains had begun to make their mark. (That’s right: There was a time when variants were not a part of everyday conversation and were alleged to be just some scientists’ attempt to gain extra attention.)

COVID-19 has taught many times over that there are no simple answers. 

But providers can be sure of one thing: There will be more hills and valleys in 2022.

This pandemic will pack more punches before it’s played out. Some of them will be of the “sucker” variety, some will be ironically labeled “jabs.” Some of them will be roundhouses.

The key won’t be whether you, as a provider, will get bounced around some more. Assume you will. The biggest indicator will be how you roll with the punches, and whether you answer the bell each time.

James M. Berklan is McKnight’s Long-Term Care News Executive Editor.

Opinions expressed in McKnight’s columns are not necessarily those of McKnight’s.