Why Would We Go Back to Pre-COVID Procedures?

It’s time to embrace the positive changes we’ve made in operations during this crisis.

By Liz Jensen, Clinical Director, Direct Supply

“If we had the right regulations in place before all of this happened, why did long-term care need waivers to take better care of people?”

This question, in various forms, has been asked frequently in the past few months.

For those who work within or receive services from the aging services sector in the United States, the hurdles involved in delivering care to older adults is not news. However, if there is one thing the COVID-19 pandemic has uncovered, it is that it’s time to remove the long-standing, bureaucratic barriers that prevent effective, efficient care for seniors.

Thankfully, the administration — and Centers for Medicare and Medicaid Services (CMS) Director Seema Verma in particular — has taken a positive step forward by prioritizing badly needed funding to protect residents and staff at senior care facilities. However, there’s still more to be done.

Unfortunately, 8 out of 10 deaths from COVID-19 in the United States have been 65 and older and 43 percent of all U.S. coronavirus deaths are residents or staff members in nursing homes. Without continued attention, that number will only rise.

At the onset of the pandemic, CMS announced waivers to help skilled nursing facilities (SNFs) address the outbreak, cut back red tape, and make it easier to care for seniors — changes advocates have been requesting for years. Overregulation and underfunding constrain the benefits that rapidly advancing research and technology can offer in improving outcomes, increasing access and reducing costs to care.

However, as the months have passed, the conditions for these waivers are shifting, and we could find ourselves back in the same circumstances that got us here.

Skilled nursing facilities (SNFs) are licensed health care centers, regulated by CMS, for people who need a higher level of medical care than what is offered in an assisted living facility. There’s more than 15,000 of them across the country, and nearly  4 million  Americans spent some time receiving care in SNFs in 2014.

As part of the Nurse Executive Council, I have the honor of working with hundreds of nurse executives and nurse leaders in senior care across the country. Throughout this unprecedented time, healthcare staff have been a vital lifeline to the people who receive services in our SNFs and assisted living centers.

Caring for our nation’s elders and their nursing staff is critical to the health and well-being of our economy and nation, and it was incredible to watch CMS implement the changes nurse executives have long fought for in only 10 days in March.

In the midst of a global pandemic, we’ve caught a glimpse at a new era of healthcare. Between eliminating the three-day stay requirement and reducing restrictions on telehealth services, our most vulnerable population will not have to risk exposing themselves to the virus in order to access care.

There is no longer a reason for regulatory reform to be a slow and arduous process — we know it’s possible to make the right decisions in a short timeframe. It appears CMS is also aligned with this new thinking. Their recently announced Patients Over Paperwork initiative is aimed at creating efficiencies and improving the beneficiaries’ experiences.

Why then, when we have come so far in only a matter of months, would we risk letting these waivers slip?

As the death toll continues to rise, this matter is far too important for federal regulators to wash their hands of it. According to CDC estimates, the number of COVID-19 cases will get even worse in the months to come. We’re at a critical inflection point in our country.

It shouldn’t take this much suffering for leaders in Washington, D.C. to recognize meaningful and more permanent reform is needed. Let us learn from this, let us act on this, and let this mark the beginning of a transformational change in aging care in our country.


Liz Jensen is the clinical director of Direct Supply in Milwaukee. She has served the long-term care community for 30 years, advocating and advancing the case for innovation in technology, products and processes that improve resident outcomes, drive caregiver efficiencies, and reduce operating costs in senior care organizations.