A systemic underinvestment in senior care has left workers and those they care for exposed to unnecessary risk, calling into question nursing homes’ viability, operators and policy experts said.
While some providers were able to adapt more quickly than others, the response to the pandemic has largely been a reactive one. They are hopeful that the crisis will shape a new approach to post-acute and long-term care, both from an operational and philosophical perspective, but to this point the outlook has been bleak.
“Our nation has decided that elderly people are dispensable,” said Daniel Reingold, CEO of Hebrew Home at Riverdale in New York City. “We are prepared to reopen the country knowing that most of the people who will suffer and die are the old and infirmed people in nursing homes, instead of recognizing the ageism in this country.”
More immediately, skilled-nursing, assisted-living and other senior-care facilities need a greater share of the COVID-19 relief funding as well as priority testing and equipment, advocates said. Although long-term care facilities have been the most susceptible to the outbreak, they were among the last groups to get personal protective equipment, testing and funding, said Terry Fulmer, president of the John A. Hartford Foundation, which works to improve care for older adults. “We love to say we know someone who is 100 years old, but we as a society look the other way in ensuring we provide quality care.”
Taking a longer view, advocates are pushing for a comprehensive investment in public health, an improved payment structure, a redesign of physical space, a revamped regulatory framework and a more cohesive care continuum. “Our entire healthcare system is set up to do transactions as efficiently as possible because they all follow the money, whether you are for-profit or not-for-profit,” said Vincent Mor, professor of health services, policy and practice at Brown University’s School of Public Health. “The virus has shown all the flaws that are apparent in a maximally efficient, transaction-based healthcare system.”