State program to aid nursing homes in fighting COVID-19 falling short of goals, some home officials say

Nov. 23--A state program that provides medical professionals to assist long-term care providers in preventing or halting the spread of COVID-19 has benefited some homes, but changes are needed to address shortcomings, a trade group for the nursing home industry says.

State officials have touted the Regional Response Health Care Collaborative Program as a tremendous success that helped save lives by providing critical clinical, educational and administrative support to the state's nursing homes and other long-term care facilities.

Officials within the nursing home industry say the program has fallen short in assisting homes in key areas: staffing shortages, obtaining personal protective equipment and assisting in paying for testing of residents and staff.

The lack of support in that area is particularly frustrating because there appears to be sufficient funding to assist the homes with all of their requests, said Zach Shamberg, president of the Pennsylvania Health Care Association (PHCA), a trade group that represents 350 nursing homes and personal care homes statewide.

The state earmarked $175 million in CARES Act funding for the program, which launched in July. It contracted with six healthcare systems to cover 11 regions. Locally, Geisinger Health Care System provides services to 17 counties in the northcentral and northeast region, including Lackawanna, Luzerne, Susquehanna, Wayne and Wyoming counties.

According to a monthly report DHS prepared in September, the health care systems project they will spend about $148 million of that total by Dec. 30, when funding for the program expires. Unless an extension is granted, any money left over must be returned to the federal government, said Erin James, a spokesperson for the state Department of Human Services, which oversees the program.

James said the projections are not an exact science. DHS anticipates using the full funding, but is hopeful the federal government will extend the expiration date and provide additional funding so the program can continue into 2021, which is critical given the recent surge in cases, he said.

James acknowledged some nursing home administrators have complaints, but said many others have commended the teams for their assistance, particularly during an outbreak.

Officials with DHS highlighted some of the program's accomplishments during a recent press briefing.

The teams initially visited each home to evaluate their COVID-19 preparedness. They continue to offer ongoing support and are available 24-7 to address any questions or issues. A rapid response team can be deployed within 24 hours to assist with outbreaks. As of Nov. 16, the rapid response teams had responded to 34 homes in the northeast region.

"The unfortunate reality of this pandemic is that outbreaks can and will happen," said Teresa Miller, secretary for DHS. "What matters most is how we catch and respond to outbreaks when they occur ... This program has undoubtedly strengthened our response. We are all concerned it could disappear when it is needed most."

Shamberg acknowledged the program has provided valuable assistance to some homes, particularly with infection control and the rapid response teams. PHCA has heard from many other home administrators who said the teams had little insight to offer above what nursing home staff already knew.

The most troubling shortcoming has been in assisting with staffing, he said. Nursing homes continue to struggle to attract or retain employees because of the risks associated with caring for COVID-19 residents. The homes expected the medical providers to supplement staff, but most report their needs were not met, Shamberg said.

The September DHS report, the most recent available, shows health care providers project to spend $15.5 million by the end of the year for staffing. As of September, just $490,882 had been spent.

Financial assistance for testing and PPE is also an issue. Shamberg said some medical providers are paying for testing, but others are not.

Several nursing home officials in Lackawanna County said, overall, they believe the program has value, but agree there needs to be more support for staffing and testing.

Nancy Newcomb, president of St. Mary's Villa Nursing Home in Elmhurst Twp., and Jim Brogna, spokesman for Allied Services Skilled Nursing Center in Scranton, said they were advised additional staffing was only available through the Pennsylvania National Guard. Neither facility has received any assistance with paying for testing.

Geisinger Health System spent about $168,000 for supplemental staffing in the 17 counties it covers, but no money on testing, according to the September DHS report.

Janet Tomcavage, chief nursing executive for Geisinger, who is overseeing the program, said the health system paid for 120 full-time employees across its coverage area. Spending in that area is not fully reflected in the September report because the invoices have not been processed yet.

As for testing, Tomcavage said all medical providers were required under their contracts to first seek payment from residents' and staff members' insurance carriers. If the claim is denied, Geisinger will pay the cost.

Shamberg said PHCA is not calling for the program to be shut down. If it continues, nursing homes want to have more input in how the funding is distributed. The group also advocates for part of the CARES funding to be paid directly to nursing homes.

DHS maintains the funding is best used to support the program, which provides critical back-up assistance to facilities at a time when their normal process is not adequate to manage the situation, James said.

"It is somewhat analogous to why we have fire companies benefiting communities instead of individual firefighters for each home," James said. "We do not believe that writing a check to a provider would have the same impact as an on-call and rapidly responsive network of professionals skilled and experienced in managing this specific circumstance to save lives."

Contact the writer: tbesecker@timesshamrock.com; 570-348-9137; @tmbeseckerTT on Twitter.

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