Update from the Health Facilities Association of Maryland
Thank you for your leadership as we continue to navigate the evolving COVID-19 pandemic. We appreciate all that you do to serve Marylanders and to advocate for your constituents.

Relative to skilled nursing and rehabilitation centers, assisted living campuses, our associate members, and people throughout our community, this an update on the current surge, the vaccine, and our path ahead.

This week is important as we turn a corner in our fight against COVID-19. The vaccines mark a new and promising dawn. However, the truth is that it will likely be several weeks or months before we are able to vaccinate everyone in skilled nursing and rehabilitation centers and assisted living through the federally contracted vaccination program. 

As you may know, CVS and Walgreens will be providing COVID-19 vaccines to protect vulnerable Americans in long-term care facilities across the nation through the Pharmacy Partnership for Long-Term Care Program. Some vaccine clinics are starting as early as this week; here in Maryland we expect them to begin around December 24. To say we are thankful for these is an understatement

This Pharmacy Partnership for Long-Term Care Program is free of charge and will provide complete management of the COVID-19 vaccination process. Skilled nursing and rehabilitation centers signed up for the CVS/Walgreens vaccination program as directed by the federal government. The Maryland Department of Health (MDH) has signed up all skilled nursing and rehabilitation centers into the national vaccination plan as well—which was the right way to go.

This vaccine distribution is critical in our fight against COVID-19 and it will save lives in our sector and across all settings. It is estimated that nationwide, the entire long-term care sector may not receive vaccinations until March. And it is likely that our battle against this virus will continue to get worse before it gets better.

The current COVID-19 surge, along with the seasonal flu, is real and is intensifying in some local Maryland communities. As we have previously shared, the biggest indicator of COVID-19 entering a healthcare setting is the prevalence of COVID-19 in the surrounding community. Therefore, as COVID-19 spreads in the community, it also spreads in healthcare settings.

While there are outbreaks, the long-term care sector is mostly preventing large hotspots through testing and improved infection control practices. We continue to be in touch with MDH/National Guard Bridge teams, for whom we are most thankful. That said, the entire healthcare industry is stretched thin for medical staff.
The State of Maryland’s expectation is that our sector will self-bridge during this fall and winter COVID-19 surge. State bridge teams are limited. The support of State and National Guard Technical Assistance Teams that have been in all 227 centers to review infectious disease protocols, staffing, and PPE has been helpful.

But again, the State’s expectation is that our sector will self-bridge more often than not. In the earlier spring surge, HFAM was proactive in coordination with the Maryland Hospital Association, UMMS, Johns Hopkins Medicine, and LifeBridge on issues of emergency RN staff supervision/training support, and in general coordination. We will continue on this front.

In addition, we are working closely with our partners and the Maryland Department of Health on getting monoclonal antibody treatment in to our centers. Remedi SeniorCare is receiving allotments of hundreds of doses per week dedicated for patients and residents in our setting. We continue to have calls with MDH leaders to get this treatment to our patients and residents in a clinically driven and medically supervised way.
Skilled nursing and rehabilitation centers provide care to Marylanders with pre-existing conditions. Because of the nature of COVID-19 relative to our residents and in diverse communities, nursing homes have been on the front lines since the beginning of the pandemic. Healthcare heroes continue do all they can to save lives.

Fortunately, there is a light at the end of the tunnel but there will still be many tough decisions ahead. Things are very intense with the current COVID-19 surge, and we are likely not near its peak.

Medicaid underfunding, workforce challenges, and the tragedy of healthcare disparities are all issues we knew about and endeavored to work on well before this pandemic began. Now after confronting these issues for years, they have been exacerbated by COVID-19. Going forward we have an opportunity for partnership, innovation, and change on these critical fronts.

Between increased costs for testing, staffing, and PPE and declining revenue due to lower occupancy, the long-term and post-acute care sector needs direct financial support in the Medicaid rate to ensure continued quality care for Marylanders in need.

Maryland is about one of twenty states that has not used the 6.2 percent increase in the Medicaid Federal Medical Assistance Percentage (FMAP) to enhance the long-term care Medicaid rate. In fact, the State of Maryland has paid nursing homes $58 million less in rates in 2020 than in 2019, and has spent fewer state dollars because of the federally enhanced rate.

As we quickly approach the 2021 Legislative Session of the Maryland General Assembly, we look forward to working together to protect and increase the long-term care Medicaid rate, ensure that providers and their healthcare heroes have the resources they need to continue the fight against COVID-19, and begin to fully address challenges presented by the pandemic such as workforce development, digital learning, healthcare disparity, and of course, quality care.

Again, thank you for all that you do. We appreciate your leadership in guiding Maryland through these unprecedented times. Together, we have an opportunity to rebuild an even stronger, healthier Maryland.
HFAM COVID-19 Center

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