Expert Views on Long-Term Care

Nearly 20 percent of Bucks County’s population is at least 65 years old. This includes community members who reside in long-term care. BCMS

Script connected with Daniel Haimowitz, MD, FACP, CMD, a board-certified internist and geriatrician in Bucks County and nationally recognized expert in long-term care.

Script: What does “long-term care” include?

“Long-term care” (LTC) encompasses a spectrum including home and community-based services, independent living, assisted living (AL) and nursing homes. AL has more residents and communities than do nursing homes but is far less staffed and has no federal regulations, while suffering from many of the same issues that nursing homes face.

Script: How did the pandemic impact LTC?

The COVID-19 pandemic has had a devastating impact on LTC residents and staff. One good thing to come out of the pandemic has been increased advocacy efforts in the LTC community. The pandemic underscored many of the problems in nursing homes. The way the U.S. finances, delivers, and regulates care in that setting is ineffective, inefficient, inequitable, fragmented, and unsustainable. A national report led to the creation of the Moving Forward Coalition, which has 7 committee focus areas: Person-Centeredness, Culture Change, Care Planning & Quality of Life; Staffing & Well-Trained Workforce; Transparency & Accountability of Finances and Ownership; Financing System; System of Quality Assurance; Quality Measurement & Continuous Quality Improvement; and Health Information Technology.

Script: What are LTC’s advocacy initiatives?

The pandemic was an extraordinarily busy time for LTC. AMDA – The Society for Post-Acute and Long-Term Care had weekly State Task Force calls, which became the State Based Policy and Advocacy subcommittee. I have had weekly calls with Congressman Brian Fitzpatrick and his District Director Kyle Melander for the past 3 years. Among many accomplishments, Congressman Fitzpatrick has co-sponsored the Nursing Home Disclosure Act (H.R. 177), landmark bipartisan legislation to improve public disclosure of nursing home directors.

AL initiatives are equally exciting. A national AL Delphi group I facilitate has written a position paper on Medication Optimization in AL. We are working with National Association for Regulatory Administration (NARA) to develop best practices for AL regulatory language. There is collaboration between AMDA and the Center for Excellence in AL called Be Well in AL to address other AL topics.

Locally, our county is supporting a new initiative to develop the Bucks County Long Term Care Partnership (BCLTP). Led by the Bucks County Health Improvement partnership (BCHIP), which links six acute care hospitals, the Bucks CMS, county leadership, and community health agencies to address gaps in community health resources, this model will be utilized to establish the BCLTP to share resources, best practices and identify collaboration opportunities.

There is much more work to be done! The value of health care professionals getting involved and building relationships to advocate for our LTC patients and their families has never been more important.