As long-term care providers band together to prepare for the local impact of the Silver Tsunami, there is one organization doing much of the heavy lifting. It’s the New Jersey Medical Association.
The local nonprofit trade association is responsible for handling all lobbying efforts in Trenton for policy and research needed by those providing nursing home care, assisted living, rehabilitation, and other long-term care services in New Jersey. are.
Sixty years after becoming a local powerhouse in the industry, they’re still finding more ways to flex their muscles.
Andrew Aronson, CEO and President of the New Jersey Health Care Association, and Charles Larobis, the group’s Director of Clinical Services, spoke about what the future holds for ROI-NJ and its members.
ROI-NJ: From your perspective and the long-term care providers you represent, what changes do you expect to occur due to the state’s growing elderly population?
Andrew Aaronson: Here’s how we’ve changed in the last few years in long-term care, especially in nursing homes. We value the people in our facilities much more than we used to. If you go back 25 or 30 years, people would receive care in nursing homes and be transferred to hospitals if they needed clinical services. It doesn’t work anymore.
andrew aronson
(Elderly) Due to population growth and hospital systems, people need on-site treatment in nursing homes. When we talk about new technology and innovative plans and strategies, nursing homes are generally doing much more than before, allowing people to be treated on the spot without having to leave the nursing home or be admitted to the hospital. The topic was that it was clinical. hospital. The same is true, to a lesser extent, of assisted living facilities, although the clinical level may be a little lower than in nursing homes.
However, at least in New Jersey, assisted living facilities are allowed to provide fairly complex clinical care to their residents, as long as they have the capacity to provide the care. That becomes an overarching theme when you think about how providers in this space have responded to demographic changes.
Charles Larobis: This demographic shift is what we call reimagining health care. As part of this, we strive to best tailor our services to our residents where they are and provide the highest quality of care. This means changes such as the transition of medical-surgical departments to skilled nursing facilities. Accordingly, the capacity and training of staff must also be on par with the needs of the population. Skills and competencies must always be at the top of the food chain to ensure that we have the resources and services to improve and sustain patient outcomes. We are nurses too, so we don’t want to miss anything.
Charles Larobis
So what’s important here is a very astute, head-to-toe assessment. A few years ago, the strategy was, “If in doubt, send them out.” You can’t do that.
Appropriate assessments must be used to care for the population and improve outcomes. And, if possible, early identification of changes in condition can reduce hospitalizations. It has many challenges, but we are positive about it.
ROI: What innovations should be included in reimagining care?
AA: In the past, every time a nurse made their rounds in a facility, the first thing they had to do when examining a resident was take vitals as they evaluated the resident. Now, there is usually technology in the room that monitors residents’ vital information 24/7, including heart rate, oxygen levels, and blood pressure.
Many tasks that nurses used to have to do when entering a room to meet a resident can now be done immediately before entering the room. We use that data in predictive modeling and analysis to look at things and say, “I have a resident in room three, and they exhibit these characteristics. Let’s make it a priority to meet them.” Please look carefully. ” Many of these remote monitoring and predictive analytics tools can be used to target interventions and prioritize who needs to be seen in a facility and when. ”
CL: Technology is here to stay. It is also important for operators to select the appropriate technology system. Because it’s not good for everyone unless it’s customized to the operator’s needs. That said, there are many options for AI-driven technology that can help reduce falls, such as smart lighting and VR headsets to identify fall risk. Falls are a big problem for residents. Remote patient monitoring is also a big area. That is becoming increasingly important.
As with some of the technology built into smartwatches, it’s important to do physiological monitoring. This allows operators to better recognize red flags. All of these can be customized based on patient parameters, one example being blood pressure trend tracking. Any deviations can be flagged, helping to detect changes in conditions early.
There are also technologies that can help operators ensure they are implementing control measures to prevent infection, such as hand hygiene. All necessary staff training to make the most of these tools is also required.
ROI: What do you see as the biggest hurdle for long-term care providers tasked with meeting the growing demands of seniors?
CL: What immediately comes to mind for me is the workforce crisis that we’re in. I’m sure you’ve all heard about it, but the big challenge, especially on the caregiver and nursing side, is the redeployment of nurses who do these things. Perform more frequent bedside assessments and address more complex needs. Perhaps automation can relieve some of the work, freeing up nurses from administering medications or assisting with medication administration, freeing up clinicians to do what is needed most: identifying early changes. It will be. Conditions are poor and a red flag is being considered. Currently, there are significant limitations in terms of personnel.
AA: There are regulatory barriers. Nursing homes in particular are a highly regulated environment when it comes to permission to operate. Problems always arise when implementing new technology and changing the paradigm of how things are done. Because technology is much faster than regulatory changes. Being bound by regulations to act in a certain way removes the flexibility for providers to innovate and change the way they do things.
If there is a change that involves new technology, we have to take it to the regulators, show them what we are doing, convince them that it is right, and wait for the regulations to change. A quick example from New Jersey: Other states have changed to recognize so-called medical technicians (or medical technicians). They are specially trained CNAs (or certified nursing assistants) who administer medications to residents, freeing up nurses to focus on other things. While many states have gone so far as to allow medical technicians in nursing homes, New Jersey does not, despite allowing assisted living.
Due to changes in our industry, it is certainly safe to administer drugs in this way, but from a regulatory perspective, the multi-year process to allow this has not yet been completed.
ROI: How do the two challenges you alluded to, workforce and regulatory issues, intertwine?
AA: There is a constant trade-off between innovating and maximizing resources to provide better care and implementing regulatory regimes that drive staffing mandates and staffing ratios. There is a push and pull. New Jersey and the state of New Jersey are demographically going against the tide. The rest of the United States. While the population of residents aged 85 and older is growing and growing faster than other populations, the care-age population is stagnant or, in some cases, declining.
In reality, the labor shortage will not improve. It could get worse. Frankly, we have to be innovative to take better care of people with fewer caregivers. To do that, we have to become more efficient. That’s why, from an industry perspective, we’re focused on helping healthcare providers leverage their resources and innovate as best they can to care for as many people as possible. That means we will continue to work with regulators to help these providers ensure they can deliver health care services. Everyone is moving in the same direction.
