As we get closer to the Biden Administration taking office, it is worth looking at the pledges and potential policies put forth. With a Democratic president, the House with a Democratic majority, and a closely divided Senate we could see more moderation and consistency in policy. This steadiness can allow the opportunity to address the COVID-19 pandemic more effectively in nursing homes and other assisted living facilities where residents continue to die in alarming numbers, and staff struggle to lower infection rates.
There is much for the new administration to consider about the impact of COVID-19 on the elderly in assisted living residences, such as facility capacity, residents, staff and personnel physical and mental health, personal protective equipment (PPE), and ventilator capacity and supplies. The Joe Biden website has a Nursing-Home-Policy file available outlining the Biden Harris plan to keep these elder care facilities safe. Steps include promoting safety and care for workers through increased testing, contact tracing, and continuous training. The plan also seeks to ensure appropriate oversight of facilities to protect resident/patient safety and wellbeing. Other measures include identifying and managing how taxpayer and resident funds are spent and provisos for bringing complaints forward. And finally, the Biden Harris policy plan outline addresses the need to increase access to home and community-based services for elderly Americans and those with disabilities.
Beyond these policy prescriptions, Joe Biden has pledged additional resources to long-term care operators/providers. Since the federal government had begun to support private-pay senior living operators in new ways during the previous administration, to blend both administration policies or transition fully to new Biden requirements will call for increased federal oversight and regulation. Already Congressional lawmakers such as Senator Elizabeth Warren (D-MA) and Senator Cory Booker (D-NJ) have legislation moving forward from July and October respectively, relating to nursing homes and assisted living facility reporting and care requirements regarding COVID-19. While adapting to Biden proposed changes, the senior housing industry moving forward must keep educating lawmakers to protect existing desirable policy benefits, particularly in private pay settings where some federal policy would not be applicable or enforceable. However, a “spillover” effect of government initiatives, like federal stimulus funding and testing access programs that must be adhered to by all facilities, is a strong possibility.
Finally, Joe Biden’s newly identified COVID-19 advisor, Dr. Michael Osterholm, has suggested a nationwide lockdown for up to six weeks to contain the virus’s spread may be necessary during a Biden administration. Dr. Anthony Fauci, the well-known immunologist who served as the director of the National Institute of Allergy and Infectious Diseases, believes that a readily available vaccine will preclude the need for a national lockdown. A lockdown would be seemingly meaningless for residents in skilled nursing and assisted living facilities who do not venture out very much. However, with the recent advent of the Centers for Medicare and Medicaid (CMS) relaxing stringent visitation rules, residents of these facilities will probably face isolation issues leading to depression, and other psychological health issues as more stringent rules will be reintroduced. The Biden administration will have to balance infectious disease propagation, and the cognitive decline of elderly patients brought about by depression, leading to other morbidities.
The Biden Harris nursing home policy will certainly be amended moving forward to be responsive to the ever-changing infection rates and data about COVID-19. Governing a country with world stature and economic influence during a pandemic is a daunting task. Joe Biden has made it clear if he is sworn in as President of the United States, the focus of COVID-19 care for the elderly will put human need first with compassionate care backed by scientific understanding.
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