While the COVID-19 crisis in nursing homes may feel like a lifetime for staffers and family members, the CEO of a major non-profit provider in New York City warned that the challenges are only beginning.
Daniel Reingold, chief executive of the Bronx, N.Y.-based RiverSpring Health, described the first eight weeks of the coronavirus pandemic, dating back to around March 1, as the “infancy” of the ongoing situation.
“I’m taking the position that this pandemic will be around for at least two years, and particularly in nursing homes,” Reingold said on a Wednesday webinar hosted by consulting firm BKD. “Regardless of whether governors ease the lockdown in their communities, in the states, long-term care providers should anticipate that, like the flu, the coronavirus is going to be with us for a while.”
The hope of a return to normalcy, in both nursing homes and among the general public, has largely rested on the development of a vaccine. But even if that were to happen quickly, Reingold cautioned that it wouldn’t be a panacea for senior housing and care providers.
“Even if we get a successful vaccine — and unfortunately, there’s no guarantee that that will happen — it may or may not have the effect in elderly people that we would like it to have,” he said.
That’s why Reingold, whose non-profit operates the Hebrew Home at Riverdale rehabilitation and nursing facility in its namesake Bronx neighborhood, has taken steps to prepare for the long haul.
The Hebrew Home is in the process of converting all of its rooms to single-occupancy over the next three to six months, a move that Reingold said should help slash infection rates by 50% and potentially ease the challenge of facilitating safe visits from family and friends.
The operator also worked to develop a testing relationship with the New York-Presbyterian health system, which allows the Hebrew Home to test all of its 1,200 employees for COVID-19 twice per week in line with New York State’s strict mandates. The nursing facility had already collaborated with New York-Presbyterian to develop four floors dedicated to COVID-19 recovery — “emphasis on recovery,” Reingold said.
In addition, the Hebrew Home is looking into new medicine-distribution technology, and offering mental health support to workers grieving the loss of residents while continuing to work through stressful times.
All of that work, and collaborative thinking with local partners, helped Reingold and the Hebrew Home survive what he described as “the crisis period,” the weeks where leaders were scrambling to secure personal protective equipment (PPE) and sort out testing logistics.
“My colleagues will tell you harrowing stories of getting PPE that sounded more like a drug deal in the ’70s than it did the securing of critical gear for health care workers,” he said. “It’s an embarrassment that this country did not have a stockpile of the kind of gear that we need for any kind of a pandemic.”
But in order to make it through the rest of the pandemic, operators need to focus on forging similar types of partnerships to weather the storm. Reingold noted that it took weeks of crisis to finally jolt a reliable testing apparatus into place, a problem that operators in states across the country face — and which could only loom larger in some areas that were not hit as hard initially as the New York/New Jersey metropolitan area.
“I don’t think it’s over yet, and I don’t think anybody should feel complacent at this stage of the game,” Reingold said. “It’s really, in many ways, a moving situation.”
At The New Jewish Home, a full-spectrum senior care provider with operations in New York City and Westchester County, leaders similarly took advantage of a key hospital partnership, according to vice president of clinical excellence Elizabeth Weingast.
Turning to Mount Sinai Health System’s infection-control physician leader, who had experience managing infection prevention efforts in five hospitals, provided vital support for the nursing provider’s own strategies.
“It’s really good to have an outside view on what you’re working on,” Weingast said. “As a close team within your nursing home, you start to realize that you need a little bit of an outside point of view — to be that second check, to make sure that you’re making wise decisions together.”
Clear communication with staff and family members will also take on even greater importance as the nursing home industry continues to sit at the front lines of the COVID-19 pandemic. For Reingold and the Hebrew Home, that meant executives working alongside frontline staffers in the same PPE that was available to them.
“If we were asking them to come in every day, every shift to expose themselves to the virus, to potentially bring it home to their own families, it was absolutely critical that they see the senior executive team right next to them wearing whatever gear they had, not any fancier gear that we might have been able to get — which was pretty limited at the time,” Reingold said.
It also means trying to highlight the victories that operators have scored amid the tragedies.
“This should not be about how many COVID deaths there were in nursing homes,” he said. “This should be about how many lives were saved, how much quality of life was continued during the most dire challenges, and how we — particularly those of us that are in the non-profit world — embraced our mission and embraced the faith that most of our organizations come from.”
Christina Villanueva, chief financial officer at the United Hebrew Geriatric Center in New Rochelle, N.Y., described how leadership at her facility put up a banner outside the facility with the number of successful COVID-19 recoveries and returns to the community — a figure that stood at 56 residents admitted from the hospital as of May 27, according to Villanueva.
“We successfully transferred 56 people back home,” Villanueva said. “Those are the stories that really need to get out there.”