As COVID-19 Pushes Hospital Patients to Post-Acute Care Settings, Supply and Resource Needs Grow, Per Premier Inc. Survey

CHARLOTTE, N.C. — Senior nursing and assisted living facilities have limited personal protective equipment (PPE) to care for a greater volume of patients, according to a Premier Inc. survey – indicating a second critical wave of supply shortages, as hospitals move to reserve beds for severe COVID-19 cases and post-acute settings see an influx of patients. While senior nursing and assisted living facilities can serve as excellent sites for less critical cases, such moves cannot overlook supply and resourcing demands, Premier’s survey suggests.

Premier’s survey of nearly 2,500 skilled nursing and assisted living facilities found that 24 percent of facilities do not have N95 masks on hand, and the majority of respondents have fewer than two weeks’ supply of surgical masks, isolation gowns and face shields. Other key products for which they have supply concerns include thermometers, exam gloves, alcohol pads, soap/detergent and hand sanitizer. Ninety-six percent are implementing PPE conservation strategies.

“In this next phase of the outbreak, states and healthcare providers are contemplating how they can best provide care for patients who need medical attention but are not critical care status,” says John P. Sganga, Senior Vice President of Alternate Site Programs at Premier. “Senior nursing and assisted living facilities can provide quality care for these patients, but this shift will increase their resource and supply needs, from PPE and tests to staffing. We already know that active cases of COVID-19 create surge demand of up to 17x for hospitals’ supplies, and our survey shows that nearly half of these post-acute facilities are already dealing with staffing challenges and that PPE remains elusive. Premier’s e-Commerce marketplace, stockd, has created a repository of conservation guidance and alternative production methodologies for key PPE, and we continue to collaborate on other solutions to help providers through this unprecedented period.”

Seventy percent of senior nursing and assisted living facilities in Premier’s survey say they are not fully prepared to treat an increasing number of COVID-19 cases as the virus surges. Furthermore, 48 percent of respondents say they are experiencing challenges with staff attendance as a result of COVID-19.

States are approaching capacity planning in nursing homes differently, as determined by hotspots. New York, for example, ordered all nursing facilities to accept hospital discharges, including patients who have tested positive for COVID-19, while Massachusetts is beginning to empty nursing facilities to become dedicated sites for coronavirus treatment.

“States and providers must think strategically about how they admit patients from hospitals or move patients across alternate care sites, particularly since senior citizens are a population already vulnerable to COVID-19,” Sganga says. “Premier continues to advocate for and work with our members to coordinate across the healthcare system, work with the government, and support programs that help get resources to sites with the greatest need. Our hope is that this survey data provides key early insights for decision-makers who are beginning to map out new care sites for patients through the outbreak.”

Survey Methodology

Premier’s survey was conducted from March 30-April 7, 2020, and sent to a representative portion of non-acute care providers in the Premier membership. Approximately 183 skilled nursing and assisted living providers responded, representing 2,492 facilities and more than 200,000 beds, or approximately 8 percent of the total skilled nursing and assisted living beds in the United States provided responses.