Mitigating the Impact of COVID on Post-Acute Facilities

Much of the world seems to have decided that COVID is a thing of the past. People have breathed a sigh of relief, acknowledged that the impact of COVID created many challenges during the past two years, and are excited to move on to a future that looks a lot like the status quo they’ve long known. However, in post-acute care, we know that reality looks a bit different. The impact of COVID on the healthcare industry is hard to ignore. So, what have we learned from COVID? We know that long-term care facilities, nursing homes, and skilled nursing facilities can’t put the pandemic in the rearview mirror. For some leaders, changes in healthcare due to COVID feel discouraging or even isolating, but there is another path forward. This is a chance for long-term care leaders to step out as innovators in an ongoing pandemic, setting the tone for our organizations, communities, and the world overall as it strives to move forward in a post-COVID world.

What We Know About the Impact of COVID

Predictions about COVID’s impact range from minor inconveniences to horrific outcomes. But what we know for sure is that, especially in the world of post-acute, there’s a long road ahead. Here’s why.

1. The Elderly Still Suffer the Most

The impact of COVID-19 on human life is undeniable, most notably among the senior population. COVID-related deaths are heavily concentrated in those over the age of 65. In fact, three out of four deaths occur in a demographic that makes up only about 16% of the U.S. population—that’s about 300 deaths every day. As older Americans (and the immunocompromised) remain the most vulnerable to the pandemic, post-acute providers will feel ongoing pressure.

2. Numbers Predict a Winter Surge

While hospitalizations and deaths across the country are trending downward, current case numbers seem to be pointing at a winter surge. The impact of COVID is being especially felt in states in the northeast, and Montana, Oregon, and Washington are also seeing cases climbing.

3. Europe Is a Harbinger

We’re deep enough into the pandemic to have learned to recognize a few patterns. One of those is that when cases rise in Europe, it’s likely that we’re going to see a jump in U.S. numbers as we enter cooler weather. The European Centre for Disease Prevention and Control has tracked an increase in cases starting around the start of September—which is similar to rates in late July under the BA.4/BA.5 wave. While we do have more immunity in the U.S. because more people have been infected, that immunity is waning.

4. Our Stakes Are Higher in the U.S.

The coming BQ.1.1 and XBB variants are better at evading immune system defenses, which could lead to higher transmission rates and more breakthrough infections in patients who are vaccinated or who have been exposed to the virus. On top of that, monoclonal antibody treatments tend to be variant-specific, meaning that new variants will be more challenging to address. The processes we’ve relied on to protect our elderly and immunocompromised residents and patients from the impact of COVID-19 will likely be less effective.

COVID Impact on Healthcare: How Leaders Can Move Forward

The combined impact of COVID on the healthcare industry means that post-acute leaders are facing a future that looks very different than the past. Finding a positive path forward will mean looking for areas of hope and progress. Leaders will benefit from identifying opportunities to turn the status quo into areas where you can do things differently in adapting to long COVID, staffing shortages, and unpredictable variants.

1. Acknowledge That We’re Different

First, it’s going to be critical that we accept that, as a field, we’re working with a unique set of risks and rewards than the general population—or even healthcare as a whole. Rather than being isolating, this is a chance to innovate in addressing the specific challenges of nursing homes, SNFs, and long-term-care providers.

2. Face the Challenge of Long COVID

A study out of Canada has found that patients are more likely to access long-term care after a positive COVID-19 test. While the study found that only a small subset of people increased their use, their impact on already strained resources could be significant. For long-term-care leaders, this means that the risks and impact of post-COVID conditions will have to be part of your ongoing strategy.

3. Celebrate Progress

The road ahead might be long, but that just means there are more potential victories in your future. For example, SNFs, since the beginning of the pandemic, have made significant strides in identifying and preventing COVID-19 and reducing serious outcomes. Facilities have learned how to protect their residents from the impact of COVID and have continued to adapt as new threats emerge. As you move forward in the pandemic, continue to look for bright spots and areas of progress that you can celebrate openly with your staff and community.

4. Monitor New COVID Vaccines

Vaccination has been critical to the post-acute progress in addressing the impact of COVID-19 on society, and that won’t change. As new variants emerge, new vaccines are being developed to keep up. For example, the new mRNA bivalent boosters (both Pfizer and Moderna) target the dominant omicron strains in the U.S. With new variants emerging, post-acute leaders will need to keep up with vaccine access and messaging for both residents and staff to support long-term-pandemic success. Keep in mind that vaccines can be a powerful tool to lessen the COVID impact on staffing. A recent study has found that vaccinated front-line workers exhibited significantly milder infections, along with lower viral loads, compared to unvaccinated workers. They had fewer symptoms, shorter periods of illness, and needed less medical care—all factors that can make a difference when labor availability is stressed.

5. Lean On Tech Innovation

The impact of COVID on staffing is almost guaranteed to become more pronounced as future waves of the virus progress through the population. Your traditional approach to staffing could leave you falling behind the needs of your residents, slipping below government requirements, and facing dwindling census numbers. Now is the time to leverage every option to give your full-time staff flexibility and work-life balance. By firing staffing agencies and instead tapping into reliable float pools, you can better manage the nursing professionals available to you. It’s very likely that as the pandemic continues, the impact of COVID will cause closures of more post-acute facilities—but that’s not a foregone conclusion. Leaders like you can face the reality of a post-acute pandemic and emerge as innovators in public health and an ongoing beacon of hope for your residents and communities.

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