The leader of the nation’s largest trade group for nursing homes on Tuesday expressed confidence that with a COVID-19 vaccine in hand by the start of 2021, the nursing home industry can begin to rebuild after “the roughest five months in the history of the sector.”
“If the pandemic is over at the end of the year, and we really do have a vaccine in January, February, I think we can get through this,” American Health Care Association president and CEO Mark Parkinson said during a virtual event hosted by accounting firm Roth & Co. “I’m not sure I would have been that confident four or five months ago in saying that.”
Citing his service on a Department of Health and Human Services (HHS) panel on vaccine development, Parkinson was clear in his belief that a workable preventative treatment would be available by the start of next year.
“I think we’re going to have huge progress in the fall, and I think we’re going to have a vaccine by January,” he said.
That said, Parkinson — like other public health officials — emphasized that there will be a significant gap between the confirmation of an effective vaccine and the eventual rollout of inoculations to the general public.
“I think it’s going to take longer to get it out to people than folks realize. It’s a logistic challenge,” he said. “But I think it’s going to be a one-year phenomenon. The country basically shut down in March of 2020. I think by March of 2021, this is hopefully behind us.”
Until then, Parkinson acknowledged that the space will sit in a kind of suspended animation, kept afloat by government support and the ultimate need for institutional post-acute and long-term care for a portion of the aging population.
Since the beginning of the pandemic in March, nursing facilities have seen declines in new cases and deaths, according to Parkinson; AHCA on Tuesday released data showing that the weekly fatality count in nursing homes has declined from 3,091 on May 31 to 1,458 on July 19, though overall confirmed institutional cases are rising alongside growing community infection numbers.
Parkinson in particular praised the efforts of the federal government to provide aid to the space, noting that the average operator will have collected $800,000 by the time HHS completes its distributions.
“On the business side, a combination of really enormous resources from the federal government and some from some of the states, I think, has put most providers in a position where they can start to see some light at the end of the tunnel,” Parkinson said. “We came into this with certain objectives in D.C. We’ve been able to exceed all of them.”
But the recovery has not necessarily helped all providers equally. About 80% of operators nationwide have been able to use the federal funds to “keep their head above water,” in Parkinson’s view, while the remaining 20% — concentrated in the early hotspots of the Northeast — require additional support to offset the operational losses incurred in March and April.
In addition, occupancy — which has taken a significant hit across the country — will likely not recover for the rest of this calendar year, the CEO predicted.
“I wouldn’t be surprised if occupancy is relatively flat for the rest of 2020,” Parkinson said. “We then start gradually rebuilding in 2021, particularly when there’s a vaccine and we can get the public confidence back.”
Parkinson noted that additional regulatory attention is inevitable in the wake of the COVID-19 pandemic, both at the federal level and at statehouses across the country.
“There’ll be a lot of ideas and some of them will be helpful and some of them will be terrible, and it’ll be our job to make sure that the ones that make sense get adopted — and the ones that are terrible don’t,” he said.
AHCA’s wish list for long-term reforms includes government assistance to either build new facilities with private rooms, a key infection control lesson of the pandemic, or renovate existing nursing home infrastructure to support better infection-prevention architecture.
Parkinson additionally emphasized the group’s desire for liability protections, a controversial topic that has dominated general news coverage of COVID-19 nursing home reforms.
Industry leaders have argued that operators should not face lawsuits for problems that were out of their control during the pandemic, including shortages of personal protective equipment (PPE) and a lack of testing access. In response, resident advocates and some lawmakers have claimed that the courts represent the only real avenue of justice for families of those who died of COVID-19 in nursing homes, while also asserting that operators could have done more to prevent the spread of the virus.
The AHCA CEO pointed to Senate Majority Leader Mitch McConnell’s pledge to include such protections for health care providers and other businesses in the next Congressional stimulus package, though he allowed that it would be “a real problem” if the provisions did not make it into federal law.
That said, Parkinson predicted that the evidence would vindicate the operators in the event that lawsuits make it to trial.
“There’s a lot of good facts for us,” Parkinson said. “We were doing everything we could; we just didn’t have equipment. We didn’t have testing. This virus was spreading by folks who had no symptoms. All of those are facts that will help when we get to a jury.”
He also called on big-picture reform efforts to focus on infection control and a more collaborative survey system to replace a current model that he described as “horrible.”
“It doesn’t work and creates bad outcomes, and part of our job at AHCA will be to hopefully create a new survey system that will be more collaborative,” Parkinson said.