The senior living industry is in “jeopardy” as coronavirus cases spike throughout the country, and has an immediate need for “on-the-ground resources” for personal protective, testing and staffing, according to industry experts participating in an Argentum Capitol Hill briefing on Thursday.

Argentum called on Congress and the administration for targeted, direct relief to assisted living, independent living, memory care and continuing care retirement communities in a spending bill prior to the Dec. 11 expiration of the current appropriations package. 

“These communities have been left far, far behind despite the fact that they care for the same, vulnerable people” as nursing homes, said Maggie Elehwany, Argentum’s senior vice president of public affairs. “This disease does pick winners and losers, and sadly, it’s often this aging population.”

Senior living communities, Elehwany said, offer choice for families who don’t have the ability to care for their loved ones, dignity for the final years of life and security that older adults are being cared for 24 hours a day. 

Compounding losses

The senior living industry is projecting losses of $11 billion to $15 billion due to additional PPE, staffing and infection control costs during the pandemic. Additional staffing is needed for testing, monitoring and implementing of enhanced infection control and cleaning protocols, according to executives. Compounding these losses are drastic reductions in resident move-ins due to the pandemic. 

Some communities, Elehwany said, are reporting a 75% decline in move-ins compared with the same period in 2019. An Argentum survey revealed 45% of assisted living, memory care and other senior living providers have yet to receive grants from the Provider Relief Fund of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, and almost 40% of providers said they foresee closures without additional help. 

“These losses are long-term, compounding and unsustainable,” Elehwany said, adding that providers are trying to “hold on” and prepare for a tough road ahead as coronavirus cases increase. “Congress and [the Department of Health and Human Services] have forgotten part of the most vulnerable population to COVID-19 — that is the senior populations that live in senior living, memory care and continuing care retirement communities. That is 2 million seniors out there — more than the number of seniors that live in nursing homes.”

If communities are forced to close, it affects not only more than 1 million employees but also the 2 million residents who chose those communities as “their last home,” she said.

“These are facilities families selected to end their years in safety, security and direct care,” Elehwany said. “All of that will be uprooted if these are forced to close.”

Paul Williams, Argentum’s vice president of government relations, said that senior living helps preserve the safety net for older adults in America, providing care at half to two-thirds the cost of a nursing home stay. 

“Senior living communities provide less restrictive, more affordable settings than nursing homes and save American taxpayers billions of dollars in Medicaid long-term care costs,” Williams said, adding that surveys show satisfaction scores in the 90th percentile for residents and families. “Not only are they saving money and living in less restrictive settings, but they are very happy in these settings.”

Caregiver fatigue

The other critical factor in the COVID-19 crisis are the caregivers providing that direct care. 

Chris Hyatt, president of New Perspective Senior Living, said that senior living is providing increasingly specialized care to residents, adding that “pandemic fatigue is real” among the more than 1 million front-line caregivers.

“We’re caring for more seniors than nursing homes and hospitals combined, yet we have only received a fraction of provider relief funds,” Hyatt said. “We’re approaching a point of unsustainability.”

Elehwany pointed out that the first distribution of aid to senior living was in September and only covered 2% of expenses. Many providers are still waiting for that relief to arrive. 

“Here we are eight, nine moths into this pandemic, and some facilities are just getting their first trickle of relief,” she said. “We can’t do that to these senior populations. We need direct, targeted funding now.” 

Testing

Another challenge facing the industry is testing, briefing participants said. Elehwany said much of the federal testing disseminated to long-term care facilities is insufficient or inaccurate — there are not enough tests to meet needs, and state and local mandates often require additional polymerase chain reaction (PCR) molecular testing, with costs incurred by communities. 

And although the federal government has purchased and distributed rapid response Abbott BinaxNOW tests to yellow and red counties with higher rates of COVID-19 cases, Elehwany said all facilities are in need of testing to help mitigate the spread of the virus. 

Hyatt said senior living needs PCR tests — the gold standard for testing — calling it an efficient, effective and inexpensive way to mitigate the spread of the virus, along with masking, hand hygiene, PPE and social distancing. Antigen tests, he said, are not the best use of testing in asymptomatic individuals.

“We could truly start to see the mortality rates drop across the country if more was put toward these millions of seniors instead of just popup tents all over the country for everyone else,” Hyatt said. “If we really want to truly protect the vulnerable we serve, we need to move swiftly to that type of testing.”

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