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Help slated for care, assisted living homes during COVID-19 pandemic

A triangular partnership has developed to help the state’s 1,200 personal care and assisted living homes deal with the coronavirus pandemic, which has decimated populations in Pennsylvania’s long-term living facilities.

The Department of Human Services, seven health care systems throughout the state and the Jewish Healthcare Foundation of Pittsburgh are cooperating on the Educational Support and Clinical Coaching Program to provide the homes with clinical expertise that many lack for dealing with the crisis, according to a conference call last week and a department news release.

When the pandemic began to ravage long-term care facilities, foundation members began “feeling very helpless” as they read about staff contending with the virus infecting occupants who couldn’t fight it off, according to Nancy Zionts, chief operating officer of the foundation, which was founded in 1990 with proceeds from the sale of Montefiore Hospital, created 80 years earlier by the Pittsburgh Jewish community.

The foundation asked whether it could help.

“There was no other answer but to say ‘yes,'” Zionts said.

The DHS, which regulates the personal care and assisted-living facilities, suggested a once-a-week webinar.

The foundation said “no” — twice a week would be better, Zionts said.

The department’s Office of Long-Term Living conducted a preliminary needs assessment.

The foundation could not offer expertise per se, but its members have experience in nursing, social work and health care policy, Zionts said.

The health systems — Allegheny Health Network, Geisinger, Temple University, University of Pennsylvania, Penn State Hershey Medical Center, the Wright Center, or University of Pittsburgh Medical Center — were recruited to provide the expertise and were assigned the homes within their regions.

The intention was to “uncomplicate” things and to “bring resources to people working very hard and very frightened,” Zionts said.

The homes — collectively, they serve 45,000 residents — were feeling overwhelmed, especially as their staffs usually don’t include clinicians like those employed by nursing homes, according to Wilmarie Gonzalez, the department’s quality director for Medicaid Managed Long Term Services and Supports (MLTSS) and DHS Secretary Teresa Miller.

Many homes in the eastern part of the state, where the pandemic was most intense, had already been reaching out to the health care systems in their area, Gonzalez said.

“We formalized that,” she stated.

The foundation came up with the topics for the initial webinars, including proper use of personal protective equipment, end-of-life conversations, palliative care, managing transitions, behavioral health, testing practices and dementia, according to Zionts and Gonzalez.

For each, a participating health system would volunteer to make a presentation, Zionts said.

Now, many topics arise organically from conversations between staff at the homes and the experts at the health systems, Zionts said.

The health systems, which have formed teams that include internal medicine doctors, geriatric nurses and infection control experts, often take the initiative and reach out to the homes, according to Gonzalez, Doug Jacobs, the department’s chief innovation officer, and Miller.

For the homes, it’s like having a primary care doctor to consult when a health issue arises, Jacobs said.

“It helps allay some of the fear,” he said.

The foundation has also helped facilitate conversations between staffs at the different homes, which have taken to sharing “challenges and best practices,” Zionts said.

“Helping their peers,” she said. They realize “that but for the grace of God,” an outbreak could be in their facility too, she said.

The foundation’s commitment will last “as long as they need us,” Zionts said.

The health systems are not being paid for the assistance to the homes, many of which are privately owned and managed, according to Miller and Kevin Hancock, deputy in the department’s Office of Long-Term Living.

The homes vary in size from four beds to 200, Hancock said.

Even some of the larger operations were in need of lots of help, as their focus is generally on social interaction rather than clinical care, according to Hancock.

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