Yesterday, the State released policy authorizing the creation of “Regional Hubs” to which COVID affected persons in long term care, or needing long term care services, would be transferred and housed. As I understand the policy, these COVID patients could come from hospitals, other nursing homes, assisted living facilities (licensed and unlicensed), PACE and Waiver programs.
A Hub can be a whole building, or a dedicated portion of an existing nursing home.
Red Tape Shredded
It’s clear from the way the policy is written that the idea is to get these Hubs up and running, and not to let the usual processes associated with transfer and admissions get in the way. Among other traditionally required hurdles, this policy provides that admissions may proceed without Medicaid pre-approval, a level of care determination, or even a PASARR screen.
The policy says nothing about how the facility would be compensated, nor does it say how long the designation will last other than that the designation will expire when crisis has passed. These questions and others might cause one to wonder why any facility would apply to become a Hub.
Theoretically, a facility would assume: (1) the costs of moving other residents around and creating a segregated wing,(2) the harm to their marketing in terms of admitting other healthier residents while harboring a community of COVID patients in their midst, (3) uncertainty about when and what they will be paid, and (4) the challenge of maintaining a staff for such a facility or section of a facility. And all for what? The honor of having “stepped up” in a crisis? Maybe. I hope so.
The policy statement also doesn’t say where or how many Hubs will be created. It does offer some ideas about the factors that will be considered in selection process.
The Forgotten Frontier
LTC folks are only now beginning to complain that they haven’t gotten the attention they deserve in this crisis. And it’s hard to argue the point. From the beginning it was clear that the virus focused heavily on both age and frail health – the very two qualities that coexist in LTC. And yet, it seems, there have been more resources committed to protecting the cashier at the local grocery store than the CNA’s cleaning and feeding the residents at the neighborhood nursing home.
But then, LTC has always been an unassuming industry, rarely seeking attention, and understandably so. When the public chooses to take an interest in the LTC industry, our LTC providers usually come away with another black eye. In truth, we live in a society that periodically spouts off about caring for vulnerable adults, but generally takes an “out of sight out of mind” attitude toward aging.
But I digress.
While many Michigander’s are beginning to sense an end to this ordeal, our colleagues in LTC are hunkering down for the long haul. This new policy to create Regional Hubs for COVID affected patients who need long-term supports and services paints a frank and frightening picture of the challenges ahead for this segment of our population, as well as the people who care for them.