Post-Acute Care News

Coronavirus fears continue to escalate across the country. As the number of confirmed cases continues to rise, senior care communities are growing increasingly nervous — and rightfully so. In a previous article, we stated that we didn’t believe COVID-19 to be the world-ender that many media outlets were making it out to be. And, while we still don’t believe this is the beginning of the post-apocalyptic societies so many science-fiction movies have warned us about, we can admit that things have taken a more serious turn. Our initial response could potentially be seen as dismissive, and COVID-19 is something that should not be dismissed.

Schools have shut down, closing their doors until April or later. The CDC released a statement that any gatherings of 50 people or more should be cancelled or postponed for at least eight weeks to help slow the spread of the disease. Guidelines released by the White House on March 16th suggested avoiding gatherings of ten or more people. Nursing homes have begun limiting or outright denying guest access to facilities in order to protect their residents, upsetting many families.

In the midst of the escalation, Argentum has released Coronavirus Preparation & Response Toolkit, giving senior care providers a one-stop shop for COVID-19 information and suggestions for dealing with the fallout of this pandemic.

What Resources Are Included?

Argentum’s toolkit includes up-to-date information from the CDC, resources from the U.S. Department of Labor, a preparedness checklist for nursing homes and long-term care settings, and updated guidelines for public health and safety, among other links.

What Can I Do Right Now?

The toolkit also provides an overview and instructions on five critical actions senior care providers and their staffs can take beginning now. The safety of your residents is paramount, and their demographic is the one hardest hit by this disease.

What Other Information Is Included?

The toolkit also includes everything that is known about the virus and the disease it causes so far. You can learn about the disease’s symptoms, how it spreads, and updates on testing availability. It ends with best practice ideas and suggestions for how your community should respond.

We applaud Argentum for putting this toolkit together, taking the time to gather the information and resources available and compile them into one easy-to-access location. You can find Argentum’s Coronavirus Preparation & Response Toolkit right here.

You can’t turn on a TV or read a news story without hearing about the continuing spread of coronavirus. Travel plans are being postponed, events and conventions are being cancelled, and sales on products like hand sanitizer are spiking. Coronavirus has kept cruise ships from docking and reminded the entire world how important it is to wash your hands. Many workplaces and colleges are encouraging remote work from the safety of home. It’s even been blamed for a recent thousand-point drop in the stock market.

A quick browse over the internet would be enough to convince anybody that the world is ending. But the situation isn’t that dire, we promise. However, that doesn’t mean you shouldn’t take precautions, particularly as a senior care provider. Here’s what we know about coronavirus, how it can affect your senior care community, and what you should do:

The Facts on 2019 Novel Coronavirus

Coronaviruses are a large family of viruses that are common in people as well as a variety of animals. This particular virus, designated as SARS-CoV-2, causes a disease called COVID-19 (short for COronaVIrus Disease 2019). The virus originated in China and has spread throughout the world in just the last few months. As of this writing, the worldwide death toll is just under 4,000 people, and confirmed cases number in the hundreds of thousands. Also important to note is that over 60,000 people have already made a full recovery from the virus, a fact that is not being reported as often as it should be.

Coronavirus infects the lungs. According to experts interviewed by BBC News, the disease seems to begin with a fever, followed by a dry cough and shortness of breath. Other symptoms include headache, muscle pain, and fatigue.

How Dangerous Is Coronavirus to Senior Care Communities?

Novel Coronavirus 2019 is most dangerous to the elderly and those with compromised immune systems. People with pre-existing medical conditions like asthma, diabetes, and heart disease are also more susceptible.

Because the virus is particularly dangerous to the elderly, it’s not hard to see why senior care communities would be on alert. Due to the proximity of residents to each other and to staff, one senior contracting the disease would increase the likelihood of the virus spreading throughout your community. However, just because something is possible doesn’t mean it’s likely.

Should We Be Worried About Coronavirus?

On the surface, the facts about coronavirus are scary. Almost 4,000 people have died from COVID-19 so far. However, when compared to more common diseases, it loses a bit of its fear factor. For example, over 16,000 people (and counting) have died from the flu during the 2019-2020 flu season. And that’s with widespread availability of flu vaccines.

Looking only at the numbers, COVID-19 is only lethal for a very small percentage of the people it infects. Of the cases reported so far, only 3-4% of those infected have died.

That’s not to say that the virus and the disease it causes aren’t serious. But we don’t believe it’s the world-ender the media is making it out to be.

What Can We Do to Safeguard Our Community?

That being said, there are some simple things you can do to help keep your community safe from COVID-19:

• Wash, wash, wash your hands. It goes without saying, but we’re going to say it anyway. Your staff should be washing their hands frequently. Many media outlets have released instructional videos and guides, but we like the video offered by USA Today. Click here to watch.
• Flu shots all around. While flu shots will not help stop the spread of coronavirus, fewer cases of the flu mean more resources for fighting COVID-19. Also, the healthier your residents are, the more resilient they will be toward other viruses.
• Invest in sick days. Encourage your staff to stay home when they are feeling sick. Yes, we know you’re short-staffed. Everyone is. But the ramifications of them coming to work when they’re sick aren’t worth it. Even if they don’t have coronavirus, infecting your residents with any kind of disease will weaken their immune systems and make them more susceptible to other infections.

Despite what the media coverage might make you think, coronavirus is not the end of the world. While it is dangerous, particularly for the elderly and the immunocompromised, there are steps you can take to ensure you and your senior care community remain unaffected.

Under PDPM, ICD-10-CM codes and diagnoses will impact OT, PT, SLP, NTA, and nursing components – so it's essential to stay on top of these critical operations. 

On March 25, we'll kick off a series of educational webinars with Pathway Health to help you "operationalize PDPM," starting with ICD-10 Code Management - presented by Karolee Alexander, ICD-10-CM expert and trainer.

We'll offer Q&A after, so don't miss this lunchtime learning  to keep the positive PDPM momentum going! 

Traditionally, Medicare hasn’t covered long-term care. And — spoiler alert — it still doesn’t. However, the rise of Medicare Advantage plans has opened a few doors that weren’t open before. While Medicare still doesn’t provide long-term care coverage — patients will have to subscribe to a different type of plan if they want that — it is beginning to provide coverage for certain aspects of long-term care.

So what “aspects” are we talking about?

What is the Difference Between Medicare and Medicare Advantage?

First, let’s dive into the difference between traditional Medicare (often referred to as Original Medicare) and Medicare Advantage. The first thing to understand is that Medicare Advantage, also known as Medicare Part C, is a private insurance plan. It replaces an individual’s Medicare Part A (hospital visits and inpatient care) AND Part B (physician appointments and outpatient care) with a plan from a private insurance provider. This plan must provide the same benefits as the Medicare plan it replaces. However, it also adds a lot of additional benefits not provided under Original Medicare.

What Types of Benefits Does Medicare Advantage Cover?

In addition to the benefits provided by Medicare Parts A and B, Medicare Advantage plans often offer dental, vision, and prescription drug coverage. Recently, insurance providers have expanded the coverage they offer to include benefits like meal delivery, home care services, rides to medical appointments, and home modifications like bathroom grab bars.

The benefits each plan offers varies based on the area it serves. In qualifying areas, Medicare Advantage plans can even cover grocery deliveries and transportation for non-medical needs for those with chronic illnesses. Some providers also offer options for gym memberships and fitness plans.

Are There Additional Costs with Medicare Advantage?

The cost of each Medicare Advantage plan depends on the plan itself. Most people who qualify for Medicare receive Part A benefits for free and pay a small monthly premium for Part B benefits. This is true for Medicare Advantage, as well. Some plans charge a monthly premium, while others do not. It all depends on which provider an individual chooses for their Medicare Advantage plan.

Custodial Care Vs. Skilled Care

Even with all the changes Medicare Advantage is bringing, it’s still limited in the kind of care it will cover in a long-term care environment. To understand what is covered and what isn’t, we must discuss the different types of care.

Medicare, along with most private insurance plans, pay for services that fall under “skilled care.” This includes medical services, rehabilitation, nursing, or medication administration. Medicare Advantage also covers specialized care, including stays in skilled nursing facilities, hospice care, and some home care services.

So what isn’t covered?

“Custodial care,” not typically covered by Medicare Advantage, includes services that are considered help with activities of daily living, or ADLs. These include eating, bathing, dressing, toileting, and other non-medical care. This is the type of care provided by most long-term care and assisted living facilities.

What Does This Mean for My Nursing Home?

Unless you have a contract with a Medicare Advantage insurance provider, Medicare Advantage will not cover most of the services your nursing home provides for long-term care. Stays in skilled nursing facilities and nursing homes are covered up to the first 100 days (though plans require coinsurance beyond 20 days). After that, residents are on their own. The plans should cover prescription medications and any therapies provided by your facility, however.

For nursing homes, the real benefit of Medicare Advantage is the coverage of prescription medications. Under Original Medicare, medications were not covered unless the resident was under a Part A stay. For many residents, that's a game changer.

While Medicare still doesn’t cover long-term care, the recent expansion of benefits under Medicare Advantage indicate that relief is on the way — and options could be opening up in the future.

February 14, 2020, Duluth, Ga – Prime Care Technologies, Inc. announced today via press release the appointment of Debi Damas to its product management team as Senior Director. In her role, she will contribute her post-acute care and regulatory expertise to the development of the company's SaaS services.

For the past 28 years, Damas has served in leadership roles in clinical services and product management for LTPAC organizations looking to increase quality of care, retention, and ROI.

"We are delighted to welcome Debi and her breadth of knowledge of the senior care industry as we weather the course of regulatory change," stated Jim Hoey, President and CEO, Prime Care Technologies. "Her passion for the LTPAC industry coincides with our mission to help these organizations – through technology – solve the issues that keep them up at night."

Damas holds an Associate of Applied Science, Registered Nurse degree from Cuyahoga Community College, a Diploma in Paralegal Studies/Legal Nurse Consultant, and a nano-degree in Data Foundations. She contributes to McKnight's Long-Term Care News and is a frequent speaker at industry conferences for senior care. 

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About Prime Care Technologies

Since 2003, Prime Care Technologies has equipped long-term care providers with flexible hosting, managed services and cloud software that evolve with industry demand, such as managed care optimization and mobile. Based in Atlanta with 175 employees and 200+ healthcare/IT partnerships, its technology-driven solutions are installed in 6,500+ facilities. With deep multi-vendor interoperability expertise, including the integration of 70+ healthcare applications and 3,500+ EDI payers, Prime Care Technologies offers the leading data warehouse and claims clearinghouse in post-acute care. Learn more at www.primecaretech.com – We provide the tech. You provide the care.