The state's largest trade group for assisted living facilities protested last week that state health officials have shoved them to the end of the line when it comes to distribution of resources needed to treat Covid-19 patients.
An April 24 letter to Gov. Andrew M. Cuomo and State Health Commissioner Howard Zucker from the Empire State Association of Assisted Living said those types of facilities don't receive enough personal protective equipment for workers, or enough funding to handle Covid-positive residents.
"Seniors, including those living in adult care and assisted living communities, are contracting the virus. And the providers of those communities seem to have been set up to take the blame," association Executive Director Lisa Newcomb wrote.
"Since the outbreak began, our adult care facility and assisted living facility providers, and most importantly their dedicated and hardworking front-line staff, have done everything they can with the scarce resources available to them," the letter said.
A Health Department spokesman said more than 2.5 million pieces of PPE have been sent since March to adult care facilities, home health agencies, hospices and nursing homes. Facilities are required to report their PPE inventory daily to the Health Department, which allows the information to assess their needs.
Newcomb's letter said assisted living facilities "were only recently placed on the state’s 'priority list' to receive PPE in early April, and remain under-resourced. Hospitals were prioritized for the scarce supplies and, while they are certainly deserving and in need, the front-line staff in our assisted living communities, whose goal has always been to keep residents well and out of the hospital, were left with few or no face masks, gowns, and other protective supplies."
“We've said from the start that protecting our most vulnerable populations, including adult care and assisted living facility residents, is a priority and that's why the state acted quickly and aggressively to issue guidance specifically for adult care and assisted living facilities," Health Department spokesman Jeffrey Hammond said.
"The department will continue to work with adult care and assisted living facility administrators to do everything possible to protect the health, well-being and privacy of the residents who call long-term care facilities home and to promptly address systemic facility and resident needs," Hammond said.
An April 7 state directive ordered assisted living facilities to take back any resident who tested positive for Covid-19 in a hospital as long as the facility had the ability to care for that person.
If a patient was suspected of having the virus but hadn't been tested, the facility is not allowed to bar them on that basis, and they can't test the person themselves. It's the same policy the state set up for nursing homes.
But the two types of facilities aren't the same and shouldn't be treated as if they are, argued Mark Ferreri, administrator of Briarwood Manor, a Lockport assisted living facility.
“Unfortunately we get classified in the same realm as nursing homes, but we’re different," said Ferreri, who doubles as executive vice president of the state association.
“In adult care facilities and assisted living facilities, they are often not necessarily skilled nursing facilities, so they are not typically poised to provide that day-to-day medical care they often are called upon to provide," said Dr. Bruce Troen, chief of the Division of Geriatrics and Palliative Medicine at the University at Buffalo's Jacobs School of Medicine and Biomedical Sciences.
“My concern is that assisted living facilities are being lumped into the same category as skilled nursing facilities," Troen said. “If one appreciates the differences in the different facilities, there may well be an undue burden placed upon assisted living facilities."
"We’re a residential model, not a medical model. Our residents are much more mobile. It’s a whole different population," Ferreri said.
He said an association study "estimated the increased cost of care since this started at about $12,000 per facility, per month. We will never see anything to get reimbursed on. That’s tough because these facilities don’t get reimbursed a lot to begin with," Ferreri said.
"Our Medicaid rate hasn’t been increased since 2007. It’s based on 1990 nursing home costs, so the funding has been stagnant, flat, and even been cut because of the budget problems New York State has been faced with," he said. "The (Supplemental Security Income) rate has been flat for 11 years at about $41 a day."
Despite not being prioritized, and subjected to substantial additional regulatory and reporting requirements, we are ready to work together and be part of the solution," Newcomb wrote to Cuomo and Zucker.
"But perhaps the first steps are to help put us in a position to succeed with supplies of PPE, funding to employ more staff, (making) testing available to residents and staff to help contain the virus as best we can, and some temporary regulatory relief so that our staff can dedicate their time caring for residents rather than completing voluminous paperwork and other requirements," Newcomb wrote.