Long Term Care is complex — and it’s no secret that providers have long been doing a lot with a little — providing the best care they possibly can, with limited resources.
The nurses, aides, and other healthcare providers are generally committed, savvy, deeply caring people who provide sophisticated care to people with chronic conditions. And, usually, they receive less support than they should from the broader medical community. Our Long Term Care colleagues report feeling more isolated than they'd like to.
So, a new report by the New York Times felt a bit blindsiding for our colleagues in the community.
According to the piece, “Most nursing homes had fewer nurses and caretaking staff than they had reported to the government for years, according to new federal data.” A spotlight was put on facilities that could possibly be "gaming" the Medicare system by over-reporting staffing. And a serious look was given to facilities that have provider shortages on nights and weekends — a serious potential cause of issues like falls.
These issues are serious. And the reality is that skilled nursing facilities need oversight, especially because of the population they serve. These issues certainly shouldn't be downplayed or minimized. As David Stevenson, an associate professor of health policy at Vanderbilt University School of Medicine commented, “Volatility means there are gaps in care. It’s not like the day-to-day life of nursing home residents and their needs vary substantially on a weekend and a weekday. They need to get dressed, to bathe and to eat every single day.”
That said, this New York Times article is written like an exposé. It's written as if the nursing facilities are trying to “pull one over” on Medicare and the public. And, surely — some facilities probably are being dishonest in how they run. But most are trying to do the best possible work they can in an era when there is a shortage for great providers.
For instance, the New York Times references David Camerota, Chief Operating Officer of Upstate Services Group, who said that many nursing homes are in "a constant battle to recruit and retain employees even as it has increased pay to be more competitive."
In our opinion, Long Term Care and skilled nursing facilities would improve more by being offered better tools and more support — rather than more oversight or more scrutiny. We've found that hybrid store-and-forward telemedicine can be transformative in supporting providers in connecting with collaborators outside the walls of their institution — effectively amplifying the manpower of their healthcare providers. When there is a dearth of healthcare providers, care coordination becomes essential. For someone who may be caring for more patients than they should, the ability to ask a question of a specialist or an RN, regardless of the time of day, can mean the difference between a great outcome and a sad one.
Further, in addition to the substantive impacts on patient care, a tool like iClickCare can be powerful for lessening the sense of isolation and alienation that overworked Long Term Care providers can feel. And ultimately, that sense of connection is what we all need — the providers and the patients, alike.