COVID-19 healthcare rule could worsen seniors’ financial and workforce crises

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Elderly industry executives raised concerns about a proposed federal COVID-19 healthcare rule on Wednesday in testimony reiterating their opposition to blanket requirements they call “overly prescriptive” and confusing.

The Department of Labor’s Occupational Safety and Health Administration says the final rule, proposed in March, will protect assisted living workers and other healthcare workers from exposure to COVID-19 on the workplace, but the agency has asked for comment on the rule until April 22 and has scheduled a hearing about it that began yesterday.

In her testimony, National Center for Assisted Living Executive Director LaShuan Bethea reiterated comments she made last week with American Health Care Association/NCAL Senior Vice President of Government Relations Clif Porter. , calling for consistency across regulators. Collaboration, she said, is key to maximizing compliance and mitigating confusion, especially for employers who must comply with guidance from multiple agencies.

“From the beginning, long-term care has been at the forefront of this pandemic,” Bethea testified. “We’ve had high-profile outbreaks, severe shortages of personal protective equipment, and a lack of testing and supplies.”

Despite these challenges, she said, long-term care staff members have come forward and put themselves at risk to care for the most vulnerable populations. At the same time, providers had to adapt to rapidly changing advice from multiple sources, which was often redundant and sometimes inconsistent, including advice on the use of PPE, cleaning measures, requirements for aerosol-generating procedures and employee vaccination.

Consistency is key

Following the evidence-based guidelines from the Centers for Disease Control and Prevention — which use science to determine best practices — is the most appropriate course of action for seniors service providers, Bethea said.

OSHA originally announced a temporary COVID-19 health emergency standard in June. It has required assisted living communities and other health care facilities to complete risk assessments and have written plans to mitigate the spread of the coronavirus; called on healthcare employers to provide some employees with N95 respirators and other PPE; and included social distancing, employee screening, and cleaning and disinfection protocols.

The agency withdrew the non-record keeping parts of the standard in December after failing to complete work on a final rule within the time frame set by the Occupational Safety and Health Act of 1970, then proposed the final rule in March.

The language in the OSHA standard requiring physical distancing barriers and masks has been detrimental to residents’ health, happiness and well-being, Bethea said.

“We need to find a way to minimize the risk of serious illness, death and outbreaks while protecting staff and preserving residents’ quality of life,” Bethea said.

Argentum President and CEO James Balda also testified at the OSHA hearing, saying that having residents wearing masks and partitioning rooms with plexiglass “passes to side of the fact that communities of the elderly are homes and not facilities”.

Bethea said OSHA’s permanent COVID-19 healthcare standard intends to cover a wide range of settings compared to CDC guidelines, which differ by setting. Conflicting advice, she added, can erode staffers’ trust not only in federal agencies but also in their employers.

Pennsylvania Health Care Association President and CEO Zach Shamberg testified alongside Bethea; PHCA is the state subsidiary of AHCA/NCAL. Shamberg echoed many of Bethea’s remarks, adding that attention to nuances and differences within the healthcare continuum plays an important role in maintaining the health and safety of residents and staff. staff.

“Due to the complexity of the provisions of this rule, we are concerned about OSHA’s enforcement efforts around the ETS,” Shamberg said, adding that the PHCA recommends inspectors recognize good faith efforts. suppliers to meet the standards and allow them to be flexible. meet requirements beyond deadlines.

Leaving the seniors’ residence

In comments submitted last week to OSHA, Balda argued that assisted living communities should be exempt from the requirements of the COVID-19 healthcare standard. On Wednesday, he again questioned the standard’s applicability to seniors’ lives, saying the requirements would do more harm than good to residents, add another layer of financial distress to the industry and “drive out desperately needed workers.

“While Argentum appreciates OSHA’s efforts to protect health care and health care support workers from exposure and harm from COVID-19, we believe that the nature of the services our members provide and the residences in which they are provided differ significantly from those provided by other types of establishments, such as nursing homes, and should therefore be outside the scope of “health services” as the term is used by OSHA in this regulation,” Balda said.

He said seniors’ residences have proven to be lower-risk environments than “hospital ambulatory care facilities” and “non-hospital ambulatory care facilities,” which were exempt from the ETS in certain circumstances.

Calling OSHA’s infection control requirements redundant, Balda said communities of seniors are already subject to strict infection control requirements at the state and local levels, which has enabled providers to implement “vibrant infection control programs that kept their residents safe”.

Industry associations, which jointly commented on the OSHA standard in August, agreed that consistency across healthcare settings eliminates confusion and creates a level playing field.

The American Seniors Housing Association and LeadingAge also recently submitted written comments on the proposed COVID-19 healthcare final rule.

Testimony will continue until Monday, after which parties will have 21 days to file additional evidence and data, as well as final written submissions.

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