Press Release: Geriatric Healthcare Reform

May 12, 2020

Press Release from Senator Jen Kiggans:

COVID-19 Opens the Door for Geriatric Healthcare Reform

Long before COVID-19, our long-term care facilities have struggled with staffing, funding, and substandard living conditions. Families are frustrated by their loved one’s care and staff feel overworked, underpaid, and under-appreciated. The residents in these facilities, especially those who rely on Medicaid, live in small rooms with multiple people, share the attention of a stressed nurse or care assistant, and are isolated from a society who chooses to lock them away where we don’t have to see them nor be reminded of their inconveniences.  

As a geriatric nurse practitioner, Virginia State Senator, and member of the Governor’s COVID-19 Long-term Care Task Force, I am pleased to see the state government responding and supporting the long-term care community in countering this pandemic, but the work has only begun. Not surprisingly, staffing shortages (including recruitment and retention issues) continue to be at the top of the list for areas for improvement. Although the Governor has increased state Medicaid reimbursement $20 per patient per day and has loosened some restrictions for certification of nursing assistants, facilities are still struggling as staff become ill, fearful, or quarantined themselves.

Prioritizing testing for these facilities early on would have allowed for symptomatic and asymptomatic patients to be sectioned into positive and negative care areas including isolation and quarantine rooms. Staff should have been given sufficient Personal Protective Equipment (PPE) sooner to facilitate better infection control. Instead, long-term care facilities are only recently being made a priority for PPE while starting to test all residents and new admissions from hospitals with the help of emergency staffing from outside sources such as the Medical Reserve Unit.

The infection and fatality numbers associated with the COVID-19 crisis and this susceptible age group have been staggering: out of 244 outbreaks in Virginia, 143 have been at long term care facilities, which have had 2,902 cases or 14% of the state’s total cases. 405 of the 713 deaths in Virginia as of May 5th were also in these facilities. As the rest of the country talks about drive-thru testing and antibody results and how essential these things are to re-opening our Commonwealth, my priority and point of focus remains the same: our vulnerable elderly. As of May 5th, of the 713 total deaths in Virginia, 368 were people age 80 and above, 164 of people age 70-79, and 116 of people age 60-69 (age 50-59: 42; age 40-49: 17, age 30-39: 4, and age 20-29: 2). One thing that the majority of people age 70 and above have in common is that they usually have multiple chronic health issues and an already fragile immune system.  

The response to the long-term care crisis pandemic should factor into our plans to re-open our Commonwealth for business. Since the majority of our workforce is less than age 70, most of us should be able to safely return to our jobs with the following safeguards such as wearing a mask, maintaining social distancing, following good hand hygiene, and remaining home while you are not well or in poor health. Keeping all of Virginia in quarantine with our fragile economy on the verge of collapse does not justify mandating our younger healthy adults and pediatric population to stay home. It makes sense to take an age and vulnerability-based approach to re-opening as not all Americans present with the same risk level and should not all be treated as such.

Perhaps it is time to reconsider how we do geriatric healthcare overall in Virginia. With many alternatives to crowded understaffed facilities, Virginia has a chance to think outside the box and set an example for other states. State funding for group care homes, financial reimbursement for caregivers who leave jobs to care for their elderly family members, and increased access to telehealth are some underutilized vehicles for improved geriatric care. There needs to be a paradigm shift in how we view our most vulnerable but most precious members of society. Heaven forbid we have another crisis such as this that turns our long-term care facilities into battlefields where our doctors, nurses, and staff are out-numbered and ill-prepared to fight an unseen enemy. We already have an extreme shortage of geriatric-trained providers as the pay is low, the work is hard, and the competition for better healthcare jobs is great. We owe it to the care providers to compensate them with better pay and working conditions along with tangible gratitude for a sometimes thankless but always rewarding profession. I believe the silver lining of this crisis is that this oftentimes voiceless group now has people listening. We can do better Virginia, and we must do it now.  

State Senator Jen Kiggans

Senator Kiggans represents the 7th Senate District which includes parts of Virginia Beach and Norfolk.