Assisted living and continuing care retirement communities are struggling as much as nursing homes but have not received the same attention and support, experts said Thursday during a Maryland General Assembly briefing on the effects of COVID-19 on such communities.

Sen. Delores G. Kelley (D-Baltimore County), chair of the state Senate Finance Committee, noted the availability, locations and quality of service of assisted living communities is regulated by the state. Maryland has 1,558 licensed assisted living communities with 23,687 available beds.

“We’re holding this briefing today largely because both the state and the press have failed to indicate anything separately during this pandemic regarding the existence of and the state of health of elderly Marylanders and disabled Marylanders who live in assisted living facilities,” Kelley said. “We need to understand the impact of COVID-19 on Maryland assisted living residents.”

Staffing, testing and personal protective equipment are the top three struggles for long-term care facilities, LeadingAge Maryland President and CEO Allison Ciborowski said. 

“Assisted living communities have received no federal or state funding to offset the increased costs of staffing, PPE and other purchases,” she said. “Providers are reporting double- and triple-digit increases in monthly costs.”

PPE, Ciborowski said, continues to be a challenge, as orders often are delayed or only partially filled, price-gouging is an issue, and supply chains can be unpredictable. 

The pandemic has made staffing even more challenging in a field already experiencing workforce shortages, she said. Staff members who test positive or are exposed to the virus must self-quarantine, and communities are resorting to hazard pay and bonuses to recruit workers, placing an “incredible financial burden on providers.”

And passing the cost of testing on to providers, Ciborowski said, is not sustainable. 

She called on the state to provide funding to providers based on resident capacity to offset those increased costs. 

Danna Kauffman, an attorney and lobbyist for LifeSpan, a network of approximately 300 senior living communities in Maryland and Washington, D.C., called assisted living a “very diverse industry, much more than nursing homes.” But COVID-19 affected assisted living in much the same way as it has nursing homes and hospitals, she said.

“Assisted living is actually a small business in Maryland,” Kauffman said, noting that 73% of assisted living communities can accommodate nine or fewer residents, and 14% can accommodate 10 to 16 residents. 

Steveanne Ellis, Maryland long-term care ombudsman, said the pandemic has been “life altering” and has dramatically changed how the advocacy program operates — from calling and delivering meals to residents, to virtually meeting with facilities, to providing education and resources to the public. The impact of social isolation is causing much stress and frustration among residents and staff members, she said.

“It’s harder than it ever has been,” Ellis said. “A lot of calls are difficult with residents’ families. These calls are very stressful and difficult for us.”

In other coronavirus-related news:

  • The Centers for Disease Control and Prevention on Friday published information intended to help the general public decide whether they should go out and what steps to take if they do. “In general, the more closely you interact with others and the longer that interaction, the higher the risk of COVID-19 spread,” the agency said.
  • The National Governors Association on Thursday released strategies for COVID-19 response for populations receiving long-term care.
  • Visits to assisted living and residential care communities and skilled nursing facilities in Oklahoma can resume today in a phased approach, according to an order issued Friday by Gov. Kevin Stitt. “Outings, group meals and communal dining shal be in accordance with guidance issued by the Oklahoma State Department of Health based on recommendations from the Centers for Disease Control and Prevention,” the order said.
  • Missouri is officially set to reopen Tuesday, but assisted living communities and nursing homes are waiting for more guidance from the state. “At this time, the Department of Health and Senior Services is working closely with  the long-term care industry to issue guidance on safety and logistical reopening long-term care facilities that aligns with the situation in each community and individual facilities. We expect to publish those recommendations within the next few days,” Gov. Mike Parson said Thursday.
  • Idaho has developed protocols for reopening assisted living and other long-term care settings.
  • The South Carolina Department of Health and Environmental Control sent a letter to assisted living communities and nursing homes in the state last week to clarify that visitors can see their loved ones through closed windows but are prohibited on facility grounds and in back yards and fenced-in areas.
  • The executive director of the Arizona Public Health Association is calling for more intense testing in assisted living communities and skilled nursing facilities.
  • The AARP wrote a letter to Arizona Gov. Doug Ducey on June 10. “[A]s your administration determines how to spend its $1.9 billion from the COVID-19 relief fund that Congress allocated to Arizona as part of the CARES Act, we urge you consider funding to address COVID-19 in nursing homes, as well as in assisted living facilities, and other LTC facilities. This could include funding for personal protective equipment (PPE), testing, staffing, disinfection, telemedicine, communications technology and facilitation of virtual visitation with family members,” AARP AZ State Director Dana Marie Kennedy, MSW, said.
  • Arizona cannot answer this critical question about its COVID-19 spike: How much of this spike can be attributed to congregate care settings and how much is community spread?
  • As of Thursday, more than 80% of the people who live or work in Florida’s assisted living communities and nursing homes had been tested for COVID-19 as the state approaches its goal of getting all of them tested.
  • The Washington state Department of Health on Friday said that it has not made much progress on broad testing in assisted living community memory care units. The department originally hoped to complete that testing by June 26.
  • The Pennsylvania Department of Human Services has announced a request for applications for its new Regional Response Health Collaboration Program, which will aim to support COVID-19 readiness and response, improve infection prevention, and facilitate continuity of care and other services provided by personal care homes, assisted living communities and nursing homes to mitigate risk of disease spread to staff members and residents.
  • Georgia Gov. Brian Kemp has issued a new executive order, effective June 16 to 30, that says people aged 65 or more years do not have to shelter in place any longer. The order does not apply to assisted living and personal care home residents, however. A few other restrictions exist as well.
  • Senior living communities strike a delicate balance to protect and encourage residents and their families, according to this article.