Part 1: Drawing from Experience Leads to Many Recommendations
In preparation for serving as the Midwest representative on the National Coronavirus Commission for Safety and Quality in Nursing Homes, Mark Burket, chief executive officer of Platte Health Center, set out to gather the thoughts and perspectives of his colleagues on the daily and compounded pandemic-related issues nursing homes face. One phone call he made was to South Dakota Foundation for Medical Care’s (SDFMC’s) Lori Hintz, RN, who serves as a quality improvement advisor for nursing homes in South Dakota through the Great Plains Quality Innovation Network (GPQIN).
Based on her deep-seeded relationships and years of experience working with nursing homes, the Centers for Medicare & Medicaid Services (CMS), and health departments, Lori and the GPQIN team members were able to offer Mark an arsenal of suggestions. Being a nursing home administrator, Mark also has daily interactions with nursing home staff and residents and plays a significant advocacy role statewide. With Mark’s participation on the Commission, he shared these recommendations nationally and a few made it to the final report!
Lori and the GPQIN team recommended multiple quick implementation strategies and actions as well as long-term strategies on behalf of South Dakota nursing homes.
The purpose of the National Coronavirus Commission for Safety and Quality in Nursing Homes was to convene experts to address safety and quality issues facing the nation’s nursing homes during this pandemic, and to put forth recommendations and best practices on infection prevention, safety procedures and quality of life for residents in nursing homes. Due to the fact that the nursing home population has been disproportionately affected by coronavirus with a death rate greater than 40% according to multiple sources, the urgency was noted, and the National Coronavirus Commission was developed.
As one can imagine, there was a plethora of recommendations the group put forward. What finally emerged were 27 recommendations and associated action steps that nursing homes, leadership, staff, residents, and others can take to help mitigate the spread. These recommendations were organized into 10 themes:
- Testing and Screening
- Equipment and PPE
- Workforce Ecosystem: Stopgaps for Resident Safety
- Workforce System: Strategic Reinforcement
- Technical Assistance and Quality Improvement
- Nursing Home Data
There were two recommendations that made the final list from SDFMC lead Lori Hintz and the GPQIN team members, including the strike teams and the physical environment. Both are respectively located under 8A and 9A-C in the report.
Commission members were given the option to approve or object to each of the ten recommendations. The biggest objection that Mark had was related to the requirement that all nursing homes across the nation have an infection control staff member. He said this was virtually impossible for nursing homes in South Dakota. In doing his homework, Mark was informed that there are only 20 certified infection control individuals in the state of South Dakota, and with a total 103 nursing homes it would be impossible to meet this requirement. His thought process on objecting to this recommendation was not to paint nursing homes into a corner and to hold them accountable for something that may not be possible for them to achieve.
Part of the long-term goals discussed the infrastructure of many nursing home buildings that were constructed well over 30-40 years ago and are not capable of meeting today’s infection control standards. With superbugs such as MRSA and CRE, communal living is not ideal in today’s world.
To view the full independent Coronavirus Commission for Safety and Quality in Nursing Homes report, visit here: cms.gov/files/document/covid-final-nh-commission-report.pdf
To view the Trump Administration Response to Commission findings, visit here: cms.gov/files/document/covid-independent-nursing-home-covid-19-federal-response.pdf