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Skilled-Nursing Facilities Navigate the Pandemic

Industry leaders discuss lessons learned from the crisis and spotlight challenges and opportunities in the “new normal.” This webinar is the first in our Commercial specialty lending series “Managing Through Challenging Times.”

M&T Bank and its Group Vice President, Healthcare Banking, Christopher Callaghan, recently hosted a panel discussion on the impact of COVID-19 on the facilities in the skilled-nursing industry. The conversation focused on three key topics: crisis mitigation and the initial response to the pandemic; economic impacts of the virus; and navigating the post-COVID landscape.

The panel featured:

  • Richard Bane, President and CEO, Bane Care Management LLC
  • Bob Griffin, Managing Partner, Krokidas & Bluestein
  • Michael N. Rosenblut, President and CEO, Parker Jewish Institute for Health Care and Rehabilitation

Crisis Mitigation and the Initial Response to COVID-19

Before starting the discussion, Christopher Callaghan spoke about M&T Bank’s long commitment to the healthcare sector and the lasting relationships the bank has built across industry. He then introduced the panel and asked Richard Bane to talk about his organization’s initial response to the pandemic.

Bane began by sharing his thoughts on the pandemic and how his facilities initially responded to it. Several of his centers experienced early outbreaks of the coronavirus, which gave Bane important insight on what was needed in terms of infection control and communication planning.  

“From the beginning, I adopted an approach using the three Cs: remaining calm, remaining compliant and to communicate. A former business school professor helped me evolve that into the seven Cs after we added being confident, being collaborative, providing compassion, having cash and, lastly, conserving cash. These seven Cs have guided our response to the pandemic within our facilities and across the state.”

As the severity of the pandemic increased, Bane’s main goal was to ensure he was doing everything he could as a leader to stay ahead of the curve and taking in as much knowledge as possible. He focused on staying connected with the news and understanding what was happening, which helped predict what the business could expect to occur in the future. “That ended up being a successful strategy for us,” he explained.  

In addition to information gathering and establishing clear response protocols, the panelists reported that appropriate staffing plans for each facility and care center played an important role in responding to the pandemic. “We brought it down to a nuts and bolts level,” explained Michael Rosenblut. “We had to make sure we had the appropriate number of staff on hand to provide care to all our residents.”

Managing the Economic Impact

While skilled-nursing facilities will face many economic and financial implications of the pandemic, a key area of concern has been covering the cost of testing employees and residents for the virus.

Rosenblut pointed out that he feels fortunate New York State has mandated insurance companies help cover the cost of testing. “We are still waiting to see what coverage will look like. But to put things in perspective, our normal lab costs are around $35,000 per month,” he added, “and if we don’t have help from the insurance companies, our costs would jump to $100,000 per week.”

Another component of managing the economic impact of COVID-19 has been understanding the legal and regulatory environment at both the state and federal levels. Bob Griffin, Managing Partner at the law firm of Krokidas & Bluestein, noted that several of his clients in this space need assistance managing issues with the Occupational Safety and Health Administration (OSHA)

“The OSHA representatives do not want to come to the facilities because they want to avoid contracting the virus, so we try to send them photos for review,” he said. “They are picking and noticing the smallest things. In one case, a reviewer commented [that] someone’s mask was not properly secured over the ear, so our client was marked for that.”

Beyond regulatory issues, another financial challenge confronting care facilities is disruption to the supply chain for items like personal protective equipment (PPE) and ventilators. This disruption has caused prices to increase steeply and has opened the door for price gouging.

“Since the beginning of the pandemic, we’ve spent over $525,000 on supplies at the Parker Institute,” said Rosenblut. “We used to pay 25 cents per mask, and because of price gouging, we’re now paying $1,000 for a mask — and that is not an exaggeration. It’s forced us to look to alternate supply chain sources.”

Another area where care facilities are dealing with the economic fallout from the pandemic is reputation management. Rosenblut explained that his organization has had to defend itself against incorrect information published by the news media. This negative coverage has also prompted the company to rethink its approach to marketing and brand management going forward. “We need to take a different look at what we’ve done in the past. For example, instead of just saying to the general public, ‘Hey, we’re great,’ we need to start stressing some of the clinical areas so people understand better.”

Building on Rosenblut’s points, Bane echoed that several success stories have emerged from the work his facilities have performed since the start of the pandemic in early March. Looking ahead optimistically, he believes that the pandemic will eventually make the skilled-nursing industry stronger as a whole.

The Post-COVID Outlook

As more states are opening, the skilled-nursing facility sector is in the process of navigating what a post-pandemic world will look like. One area of concern is whether there will be a second wave of cases in the fall, and the impact of flu season and how sustainable the new protocols will be for care facilities.

When asked for his thoughts on preparing for further outbreaks and keeping up with new processes and regulations, Bane said the response depends on funding. “We were already operating on thin to no margins to begin with. So, without additional financial and reimbursement support, financially they won’t be sustainable.”

Building upon Bane’s thoughts, Rosenblut said that his facilities have been stockpiling PPE and other supplies, but he is still concerned about the lasting impact on supply chains.

Looking back at the lessons they have learned since the pandemic took hold, Bane said the biggest difference in dealing with COVID-19 is the fact that so many people were carriers of the virus, but did not show any signs of symptoms. “Ultimately, given the lethal nature of this virus, we are going to need a vaccine.”

In terms of the larger impact on the skilled-nursing industry as a whole, for Rosenblut it goes back to reputation and image management. “We need to focus on the rating we receive and ensure that we demonstrate the value that we provide to our acute care partners and to the insurance companies.”  

Final Thoughts

Callaghan closed the discussion by thanking the Bane, Griffin and Rosenblut for participating and emphasized the bank’s dedication to supporting its healthcare industry clients.

M&T Bank is thankful to be able to bring together these industry leaders who represent a much-needed service in our communities and who value every aspect of human care.

Disclosures: 

The opinions expressed within this webinar and subsequent article are those of the panelists and not those of M&T Bank, nor does M&T Bank necessarily endorse those opinions or suggestions for your own organization.

Third-party trademarks and brands are the property of their respective owners. 

This content is for informational purposes only and is not intended as an offer or solicitation for the sale of any financial product or service. It is not designed or intended to provide financial, tax, legal, investment, accounting, or other professional advice since such advice always requires consideration of individual circumstances. If professional advice is needed, the services of a professional advisor should be sought. Unless otherwise specified, all advertised offers and terms and conditions of accounts and services are subject to change at any time without notice. After an account is opened or service begins, it is subject to its features, conditions, and terms, which are subject to change at any time in accordance with applicable laws and agreements. Please contact an M&T representative for full details.

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