The COVID-19 pandemic, while extremely dangerous and challenging, offers a chance for long-term care and the therapy it offers to prove their worth, one longtime industry executive told McKnight’s Long-Term Care News.
“Honestly, I feel it brings us an opportunity to redefine how important we are. I really do,” said Lane Bowen, executive vice president and chief strategic officer for Avalon Health Care Inc. and former president and chief operations officer for Sava Senior Care. “Whatever that might mean in the future and whatever physical structure that takes in terms of our nursing homes and training, it gives us an opportunity to define who we are and how important we are going forward.”
As much as home care sounds like an attractive model, it cannot replace the rehabilitation services that are available in a skilled nursing setting, he noted.
“People don’t get better without rehab and we have to remember that,” said Bowen, who prior to joining Sava was executive vice-president and president of the Nursing Center Division of Kindred Healthcare. “We can talk about all the home-based services, which I agree with, but the fact of the matter is we have a population that relies on us, and what do we do if we gave that up? It would be sad.”
New focus on Part B therapy
While the recent pivot to telemedicine has taken away much of the human touch in therapy, the pandemic has actually helped to shine a light on one area of rehabilitation that has been overlooked: Medicare Part B therapy, Bowen said. Because the three-day prior hospital stay has been waived in the wake of the healthcare crisis, long-term care residents, who previously were considered Medicare Part B patients are now Medicare Part A — which typically are short-stay residents.
“A lot of long-term care patients are now Part A and don’t have to go to the hospital, and that’s opened people’s eyes: Maybe we’ll do more care for these individuals,” said Bowen, who began his career as a physical therapist.
He has long believed that therapists have neglected, to a certain extent, Part B residents. Part of the reason is these residents are not seen as challenging to therapists, and progress is slower.
“We’re not as sensitive to patient population declines as we should be,” he said. “That’s been my personal opinion for 42 years. They are chronic problems and they’re hard and they’re hard to correct and they’re long term.”
More eyes on LTC residents
COVID-19 has raised the bar, in general, regarding long-term care’s treatment of long-stay residents, Bowen said.
“Don’t you remember every year we had the flu, we’d do our best to take care of it?” he said. “COVID has raised the bar for us to do a better job.”
The field’s handling of the flu is actually a good template in terms of approaching COVID-19, he pointed out.
“I think the flu was not pandemic in nature, but, shoot, we all took flu shots,” he said. “I believe this was a wake-up call to say, we should wear masks, wash our hands, take care of each other, be respectful of our distance, and we can stop a lot of this.”
If he could make a change to long-term care that would have a positive effect during the pandemic, it would be to upgrade nursing facilities’ physical infrastructure.
“The average nursing home is 50 years old,” he said. “If I had unlimited funds, I would rebuild nursing homes into private rooms. There’d be no three- or four-bed wards.
He added that if he could modernize them, in terms of adding negative-pressure rooms, as well as improve care for higher-acuity patients, “we could be a really good adjunct to post-acute care.”