Ryan Iwamoto, President and Founder of 24 Hour Home Care

We’re excited to offer you two more perspectives on how the pandemic has shaped the senior care industry and what it means for the future of the industry. (You can read Part I of our series Here.)

Steve Carr is Director of Sales and Business Development at Centers health care, a leading group of qualified nursing, rehabilitation, and elderly care services in New York, New Jersey, and Rhode Island.

Ryan Iwamoto is the President and Founder of 24 Hour Home Care. 24 hour home care provides home care for the elderly and the disabled at its 16 locations in California, Arizona and Dallas.

Because COVID-19 has spread so quickly in nursing homes, it has undermined family and residents’ trust in some facilities. What do you think senior care facilities need to do to rebuild that trust during and after the pandemic?

Carr: The pandemic shed light on what, at least from the reporting, was perceived as a bad situation. We see this every day, both at the hospital level and in qualified care. I think all health care providers need to highlight how they do it Infection control and what they do to protect employees and patients.

In the long term, we need to educate the public about the role we play in providing skilled care in healthcare. Recovery and rehabilitation occur in qualified care. This was the case before the pandemic and will continue to do so as we meet this challenge. I think it is our responsibility to improve education about what we are doing to manage the outbreak and infection control, but also about the role we play.

Do you think the senior care industry will be restructured, whether that means physically redesigning facilities or introducing new policies and procedures?

Carr: I think policies and procedures took shape as we gleaned information from the early pandemic, and there has been movement in the policy and procedure world around infection control, supply chain and testing for PPE.

I don’t see any dramatic restructuring from the perspective of the physical plan. With over 15,000 nursing homes in the country, most of which have more than just private rooms, I see this is not going to change in the near future.

I think the definition of institutions and the role they play will change. We had COVID-specific facilities that we could use to isolate patients in certain centers. It will go on like this. I think in the long run there will be facilities that specialize in long-term care and a subgroup that specialize in rehabilitation and post-acute care. I think the levels of maintenance will return after pandemic and hospital care, skilled nursing, independent livingand home health care continues.

Do you believe that once COVID-19 is better controlled or even eliminated, people will return quickly to elderly care facilities? How could the pandemic have changed the way families rate facilities when seeking care for a loved one?

Carr: The recovery we are facing will not be quick in my opinion. However, it will be because skilled care facilities will play an important role in our care system. COVID will pass, but other diseases that affect so many will not. COPD, end-stage kidney disease, and heart disease require skilled care.

In choosing facilities, patients will consider who has the best track record, the best results, and which centers offer the high levels of quality required to manage a condition. Of all the alternatives that exist, patients and families will always ask, “What is best for my situation?” Institutions that can demonstrate this gain that trust.

Iwamoto: I think there will always be a need for qualified care facilities. However, we will see an increasing shift towards direct patient relocation via hospital-to-home programs. CMS has developed strategies to improve hospital capacity amid the surge in COVID-19.

In March, CMS announced the Hospital Without Walls initiative, which will ease restrictions on providing services within their four walls. In November of last year, the “Acute Hospital Care at Home” program was added to provide even more flexibility in treating patients at home. The program is designed to develop further models of home hospital care that have previously been piloted and have been successful. Six systems are now part of this program. These include: Brigham and Women’s Hospital and Massachusetts General Hospital in Massachusetts; Huntsman Cancer Institute in Utah; Health System on Mount Sinai in New York; Presbyterian Health Services in New Mexico; and UnityPoint Health in Iowa.

Are there any other systemic changes that you predict for the senior care industry as a result of the pandemic?

Carr: I definitely think the focus on the fundamentals of infection control, the supply chain, and the ability to test at scale quickly is becoming normal. I think the emergence of telehealth will go well beyond the pandemic. I would include the use of telemedicine in skilled nursing as part of that.

I think the biggest difference will be the funding mechanism and how the federal and state governments learn to be better prepared to find sustainable funding mechanisms. These mechanisms have to help with deficits. Whether it’s personnel or supply chains or all the things that need to be financed, I hope that everything will be financed reliably in the long term.

Iwamoto: We’re going to see another dynamic shift towards patients who go home after the hospital. Home care has made a significant contribution to the continuum of post-acute care. COVID-19 has just put home care center stage and has confirmed an already valuable service for our healthcare system. We also see health care finance managers looking at home care as an important investment area for the future.

According to a survey by BDO, an accounting and consulting firm, 59% of surveyed CFOs of US healthcare organizations with revenues between $ 250 billion and $ 3 billion identified home care as a priority investment, with COVID-19 being the main driver. And as the country continues to fight the waves, the demand for home care and services will continue to grow.

Paige Cerulli