By GARRY RAYNO, InDepthNH.org
CONCORD — The state needs to restart the Long-Term Care Stabilization Program, a legislative study committee was told Thursday.
Craig Labore, administrator of the Grafton County Nursing Home, said the program helped retain essential workers and provided the staff financial security until it ended July 31.
He urged the Committee to Study the Safety of Residents and Employees in Long-Term Care Facilities to recommend resuming the program.
“I advocate for the resumption of the program,” Labore said, “particularly as we head into fall and winter which is shaping up to be a very challenging time for sectors of New Hampshire’s economy and also for nursing homes.”
The stabilization fund was created to help nursing homes retain workers during the coronavirus pandemic by providing a $300-a-week stipend to essential workers.
The program allocated $75 million of the $1.25 billion federal CARES money, but ended July 31 and Gov. Chris Sununu has to date declined to continue the program that many others appearing before the committee have also said helped stabilize nursing home staffs.
When the program ended, $67.5 million had been expended leaving $7.5 million in remaining money that has to be spent before the end of the year or returned to the federal government.
Labore said staffing is currently down about 25 percent of full complement and he also urged the committee to advocate for the community college system to reinvigorate training programs for nurses and nurses’ assistants.
The COVID-19 pandemic has devastated many of the state’s long-term care facilities, affecting both residents and staff.
To date, 358 of the state’s 439 deaths from the pandemic, or 81.5 percent, have been in long-term care facilities including nursing homes.
Labore said the pandemic turned the lives of residents in his 135-bed facility “upside down.”
He said the pandemic created fear both for the residents and for staff who wonder what they are walking into each day.
“Although we try to create normalcy, it will never be the same,” Labore said, noting, “we wear surgical masks, practice social distancing and do not have large group activities like dining together.”
He said families have a tremendous amount of concern for their loved ones’ safety, and the facility is as transparent as possible to keep family members updated.
But he noted, the residents’ wellbeing has declined with the isolation and separation from loved ones. “It has been a trying experience,” he said.
When the facility had a staff member and resident test positive for COVID-19 in April, Labore said, “we were immediately branded with a scarlet letter.”
Some staff lost child-care services, he noted, and he heard others lost apartments and housing for “working in a facility with positive cases.”
He said fear also played a role in some staff members taking medical leave and several resignations.
That is why the stabilization program was important, he said. “It helped us retain staff through the end of July and gave them a sense of security financially helping them stay with us.”
Ending Isolation
The limited visitations allowed since June have helped, Labore said. “This has been incredibly important,” he said. “The emotional impact was noticeable right from the start.”
He said the visitations are a great opportunity to reestablish some form of connection between residents and their loved ones.
Committee member Rep. Paul Berch, D-Westmoreland, asked if more volunteers could be allowed into the homes with testing to provide activities as they did before the pandemic.
“We try to adhere to the recommendation as best as possible, there are some gray areas,” Labore said. “The trouble if you veer away from any sort of established recommendation there is the potential the virus will be introduced and that would be devastating in a nursing home.”
Testing family members for potential infection runs against the recommendation of only testing symptomatic cases, he said.
“There is no way to lessen restrictions without jeopardizing the overall safety of residents and staff,” Labore said. “There is not really a happy medium.”
Testing
Berch also asked about changes in testing adopted by the state to test only staff on a regular basis and to have nursing homes pay for the program.
Labore said as has been true since the beginning, the only way for the virus to get into nursing homes once they were shut down to visitors is through staff members.
But they would still test residents for security, he said.
Nursing homes will be reimbursed $100 per test by the state, while testing generally costs between $100 and $150, although some labs charge between $75 and $90, Labore noted.
He said homes will look for the best deal in their area.
The federal government provided two testing machines, but one is only 84 percent accurate which requires a regular nose swab test to verify the other test, he said.
The facility has been promised a new machine that is 97.4 percent accurate and provides results in 25 to 35 minutes, Labore said. “That would be huge.”
The state has helped the facility secure personal protective equipment especially surgical masks, he noted, but he is concerned about the national shortage of medical gloves and disinfectant wipes.
When asked if the state could help, he said, he suspects the state faces the same problem.
Occupancy Rates
He said the pandemic lowered occupancy rates, noting some beds had to be taken off-line for isolation and for a COVID-19 specific unit.
Prior to the pandemic, 94 percent of the beds were occupied, he noted, now the rate is 82 percent.
The federal government provided relief funds which allowed the facility to end the fiscal year in good shape, but noted the current year is already in deficit.
The admission process is slower and more challenging with a two-week quarantine requirement when someone enters the facility, Labore said.
Entering a nursing home takes an emotional toll even before COVID, and now a difficult situation is made more so by telling the person they have to quarantine in their room for two weeks, he said.
Dementia cases are the number one referral to the home, he said noting 80 percent of the residents have that diagnosis.
“To quarantine a dementia resident is very, very difficult,” Labore said, “and puts a tremendous amount of stress on the staff.”
The committee meets Oct. 8 at 10 a.m. and has to file a report by Nov. 1.
Garry Rayno may be reached at garry.rayno@yahoo.com.