A note to our readers: As the coronavirus crisis continues to unfold, SNN will bring you the information that you need in one easy-to-access place.
The weeks ahead will bring challenges both macro and micro, with potentially sweeping federal action needed to “bend the curve” and maintain our health care system’s ability to function — all happening alongside building-level issues facing nursing home operators and the people who keep residents safe.
Check this space over the coming week for a continuously updated roundup of brief updates that you need to keep your communities safe and running.
Illinois Nursing Home Cases Double in One Day
In a stark illustration of how quickly the COVID-19 virus can spread in a nursing home, the number of reported cases at a skilled nursing facility in Illinois roughly doubled in a single day.
After Gov. J.B. Pritzker on Tuesday announced 22 confirmed cases at Chateau Nursing and Rehabilitation in Willowbrook, Ill., authorities confirmed that the number had climbed to 46 by Wednesday evening, according to the Chicago Tribune.
That total includes 33 residents and 13 staff members at the facility, located in a town about 20 miles southwest of downtown Chicago.
Of the 288 cases in Illinois, 42 were linked to the Chateau facility, the Tribune reported — a situation that’s rapidly mirroring the nursing home outbreak in Kirkland, Wash. that served as the first major cluster of U.S. COVID-19 cases.
In that instance, the suburban Seattle facility saw a swift spread of the novel coronavirus because of insufficient infection-control practices and the sharing of staff among multiple buildings, the Centers for Disease Control & Prevention (CDC) determined in a preliminary report.
Emergency Coronavirus Bill to Boost Federal Medicaid Match by 6.2%
President Trump on Wednesday evening signed into law the Families First Coronavirus Response Act, the first in an expected series of bills aimed at protecting workers and their families during the COVID-19 pandemic.
In addition to mandating paid leave for people who work for companies with under 500 employees, the new law will boost the federal government’s Medicaid match by 6.2 percentage points.
That increase will help to bolster reimbursements for long-term care in nursing facilities — along with many other health care providers — during the crisis, but the American Health Care Association claimed that the government must do more in the days ahead.
“We fully support and appreciate the increased Medicaid funding as a first step,” the trade group said in a statement. “We need substantial, targeted, and timely funding specific to long-term care providers in the next relief effort.”
CDC Updates Protective Equipment Guidelines Amid Shortages
The CDC has released new guidance for health care providers as they grapple with an ongoing shortage of personal protective equipment (PPE) such as masks and gowns.
The updates, which cover conservation strategies for a variety of key disease-blunting supplies, come as the American Health Care Association (AHCA) warns of widespread shortages in the very near future: At current usage rates, 20% of the nation’s nursing homes will run out of vital PPE by next week, AHCA warned on Wednesday, with a further 20% exhausting their supplies by the following week.
The CDC release includes guidelines for safely reusing equipment, as well as emergency prioritization strategies for using certain items.
“We understand that many of you are very close to running out of PPE and that any supplies you receive from your state or federal stockpile need to bridge the time until more masks and gowns become available,” AHCA noted in a release to members. “Therefore, we urge you to adopt these new guidelines from CDC as soon as possible and for some, that may mean coming up with more creative ways to use or make your own PPE.”
Facility-Wide Outbreak Reported in Illinois
Tuesday brought news of another widespread outbreak in an individual nursing facility, this time in a suburb of Chicago.
Chateau Nursing and Rehabilitation, a facility in Willowbrook, Ill., has 22 confirmed cases, Gov. J.B. Pritzker announced on Tuesday — a figure that includes 18 residents and four staff members, according to a report from local news station WGN.
The initial reports of a case at the facility on Saturday prompted officials in DuPage County, Ill., to declare a formal emergency.
Willowbrook is located about 20 miles to the southwest of downtown Chicago.
Meanwhile, in New Orleans, the number of coronavirus cases at a senior living community had grown to 12 by Tuesday, with multiple others awaiting testing. CNN referred to the property, The Lambeth House, as a “nursing home,” though the facility is primarily an independent and memory care facility, according to its website.
Suspected Case Prompts PruittHealth to Suspend Admissions at GA Building
Skilled nursing operator PruittHealth on Tuesday announced that a resident at one of its facilities in Athens, Ga. had been transferred to a hospital after exhibiting symptoms similar to those associated with COVID-19.
Though tests were not conclusive as of Tuesday, the Norcross, Ga.-based operator elected to suspend admissions at PruittHealth-Grandview and further clamp down on access to the facility, elevating its internal protocols to an “Alert Code Red.”
“Only those who have been trained in protocols developed by public health officials to identify the first signs of COVID-19 are permitted to work in the center,” the company said in a statement.
The operator also alerted local and state health officials, as well as all people who came in contact with the specific resident.
“According to the Centers for Disease Control and Prevention, as the pandemic continues to spread and the ability to test increases, more cases are expected to be diagnosed, including more instances of person-to-person spread,” PruittHealth noted.
Skilled Nursing Financing Situation Fluid Amid Crisis
While the top priority for the skilled nursing industry should be resident safety, financial transactions — including acquisitions, bridge loans, and refinances — remain in progress, though the exact guidance has continued to change along with the risk levels, according to a Tuesday update from advisory services firm HealthTrust.
With a blanket federal ban on visits from all non-essential personnel at nursing homes, appraisers generally cannot enter skilled nursing facilities.
The Department of Housing and Urban Development (HUD), which backs billions in loans for nursing homes, currently requires exterior photos and inspections, along with a virtual tour of the building conducted by existing staff members via Skype or FaceTime, HealthTrust noted.
Commercial lenders, meanwhile, have begun to allow exterior inspections only, along with interior photos provided by the operator.
“In general, the lending community is adjusting real-time to keep all constituents safe while allowing business to continue,” HealthTrust CEO Alan Plush wrote in the update.
In the near term, Plush predicted that the vital nature of nursing home care may blunt the coronavirus’s impact on census levels in SNFs — unlike senior living, which could see occupancy take a harder hit as seniors decide to wait out the economic and health uncertainty before agreeing to enter a private-pay community.
“But elective surgeries resulting in rehab stays could decline, negatively impacting skilled mix for a period,” Plush noted.
He also added that the spread of the virus could lead to higher infection-control and staffing costs, particularly as frontline caregivers must isolate themselves in the event of an outbreak.
“In the event a nursing facility experiences even one case of COVID-19 expect a total lockdown, ban on new admissions, and staffing challenges,” Plush warned.