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The PAC perspective: Advantage Living Centers on Detroit’s COVID-19 surge

In our first-ever virtual care coordination summit, “COVID-19 in Detroit,” we learned how Henry Ford Health System, Advantage Living Centers and Health Alliance Plan (HAP) worked together to successfully coordinate cross-continuum patient care during Detroit’s COVID-19 surge. In recent blog posts, we’ve shared the experiences of Henry Ford Health System and Health Alliance Plan (HAP), and below we explore the post-acute provider’s perspective of the COVID-19 surge in Detroit. Sima Lerman, Vice President of Business Development at Advantage Living Centers, joined the summit to discuss the most significant COVID-19 challenges for PACs, methods to mitigate these challenges and successfully support COVID-19 patient transitions, and lessons learned.

Post-Acute Provider Challenges During COVID-19

By the time the COVID-19 pandemic reached Detroit in early March, Advantage Living Centers had already practiced drills – beginning in February – to prepare for COVID-19-positive patients. Unfortunately, there were countless unknowns in the real world: how the virus was transmitted, when people began to show symptoms, and its incubation period, among others. In managing the coronavirus, SNFs such as Advantage Living Centers faced several challenges:

Lack of COVID-19 tests

At the beginning of the COVID-19 surge, post-acute providers like Advantage Living Centers had minimal or no access to testing. Without the same testing resources as hospitals, post-acute providers did their best to diagnose presumed cases and manage COVID-19 patients in-house without infecting others or sending them to hospitals – which were already overwhelmed with an influx of patients – for testing.

Conflicting COVID-19 guidance

Though Advantage Living Centers tried to follow the latest recommendations from the State of Michigan and the CDC, this information changed on a regular basis – often daily, or even twice daily – and one organization’s guidance often contradicted that of another.

PPE shortages

When COVID-19 began to gain momentum in Detroit, SNFs such as Advantage Living Centers struggled to adequately protect facility staff due to PPE shortages. These PPE shortages led to staffing issues as employees contracted the virus, and others became too scared to come into work for fear of contracting COVID-19. During this time, the number of employees that called out sick reached an all-time high for Advantage Living Centers.

Surge in referrals

Prior to COVID-19, Advantage Living Centers’ facilities typically received 60 to 90 referrals per week, on average. Mid-COVID-19 surge, however, these same facilities received 400 referrals per week – and SNFs struggled to quickly and efficiently communicate their availability to hospitals due to referral volumes. The referral process became increasingly complex during COVID-19 as SNFs such as Advantage Living Centers worked to ensure the safety of their patients and staff, but also help alleviate the burden of partner hospitals – who were overwhelmed with thousands of COVID-19-positive patients.

Supporting COVID-19 Patient Transitions

To successfully support COVID-19 patient transitions, Advantage Living Centers maintained constant communication with its hospital partners. Participating in daily calls with its acute partners, including Henry Ford Health System, Advantage Living Centers could better understand hospitals’ needs and challenges, including ICU bed capacity and the number of COVID-19-positive cases per day. In turn, Advantage Living Centers provided updates – such as PPE or staffing shortages – which prompted Henry Ford Health System to help Advantage Living Centers secure much-needed PPE.

To streamline the referral and discharge processes, Advantage Living Centers maintained an updated CarePort Guide profile to reflect their latest bed availability, and to indicate whether they could accept COVID-19-positive patients. The survey was prompted every six hours for Advantage Living Centers staff. An accurate profile saved hospital case managers time by avoiding sending referrals to every post-acute facility in the area; instead, they could filter facilities by bed availability and their acceptance criteria, reducing the number of rejected referrals.

Lessons Learned

During Detroit’s COVID-19 surge, Advantage Living Centers learned that open and constant communication with its hospital partners was critical in managing COVID-19 and maintaining the safety of patients and staff.

Collaboration between Advantage Living Centers and its acute partners has continued and will continue. While the frequency of status updates has shifted from daily calls to daily emails, all stakeholders are prepared, and the system is in place as needed, if there is a second COVID-19 surge in Detroit.

As Sima Lerman said during the care coordination summit, “One of the main things that the pandemic highlighted was that – even though we’re all in healthcare, we all have different hurdles that we’re overcoming,” and increased transparency and communication between disparate stakeholders during Detroit’s COVID-19 surge allowed post-acute providers like Advantage Living Centers to systematically – and successfully – address these challenges.

Watch the full-length recording of our live case study, or read our full recap of the summit here.

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