Managing Post Covid-19 COPD and CHF patients in a Skilled Nursing facility

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term for a variety of progressive lung diseases including emphysema, chronic bronchitis, refractory asthma and cystic fibrosis.

 

Post Covid 19

COPD & CHF

 

“Approximately 20 percent of skilled nursing facility residents have a diagnosis of COPD and it is the third leading cause of death in the US.

COPD is often under-diagnosed and under-treated and medication adherence is poor. Physical and cognitive functions required to self-administer medications decline with age”.

 

JAMDA: COPD in Post-acute/long term care settings.

Developing Dedicated Pulmonary Re-Hab

Unit within CCRC or Skilled Nursing Facility (SNF)

 

No Direct Re-Imbursement for Pulmonary Re-Habilitation in CCRC or Skilled Nursing Facilities

 

CCRC or SNF with 10 or more available empty beds in Skilled Unit

CCRC or SNF located in (SMSA) Standard Metropolitan Service Area

 

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“if we build it they will come”

 

Program Financial Benefits (Return on Investment) If Facility Qualifies

 

CCRC or SNF is a 3 to 5 star facility located in SMSA (Standard Metropolitan Service Are) and has 10 to 15 available empty beds in Skilled Unit

Need to average occupancy of ten patients in designated unit. Medicare pays average of $540.00 per day for qualified program participants

•(ES2 / ES3 / CC2)

Potential new revenue for qualifying facility using empty beds can range from approximately $1-1.5m with an ROI ranging from $400k to $1.1M

Reduction in Return to Hospital (RTH) patients can provide an additional savings to CCRC or SNF through increased early intervention for COPD, Pneumonia and CHF  

Dedicated Pulmonary Program can provide a marketing differential for securing new admissions as referral sources recognize facility as Pulmonary Partner

Cardio Add-On option (MyNicas & SoZo HF-Dex) to treat and manage CHF patients can result in additional revenues and provide an additional marketing differential.

Financial Benefits (CCRC Pilot Program)

 

CCRC had no respiratory program and high readmission rate for pulmonary patients (23%) CCRC had Pulmonary RTH patients sent to outside higher acuity facilities. The CCRC was the responsible party but had available beds in its’ Skilled Unit .

Dedicated Pulmonary Program was established with 10-hour on site respiratory therapist 5 days a week which allowed CCRC to accept its’ RTH patients eliminating diversion to other facilities. Pulmonary program expansion resultred in new referrals.

During the initial year the unit admitted 14 new patients (3 trach patients) who required a higher level of Pulmonary Services. These patients generated in excess of 493 new patient days generating $297,304 in revenue.

In addition, Pulmonary interventions on 24 patients within the CCRC who were treated in the unit resulted in the elimination of hospital re-admissions resulting in an estimated $264,056 in potential lost revenue..

The Challenge of COVID Lung

Covid 19 can affect the respiratory system in a variety of ways and across a spectrum of levels of disease severity, depending on a patients’ immune system, age and comorbidities.

 

COVID Lung

 

“It is particularly important that patients who have underlying lung disease can certainly have worsening of those conditions with contraction or exposure to COVID-19. With this, COVID-19 can cause overall worsening of those conditions, such as asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease, etc.

 

Chris Radchenko MD UC Health Pulmonary and Critical Care

The Opportunity Post COVID-19

 

In several studies it was determined that only 13% of patients who did not have Respiratory comorbidities were fully recovered in 60 days

A significant number of COVID Lung patients with COPD and CHF will experience long term effects of prolonged pulmonary issues

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Clinically, this may appear as several conditions: severe bronchopneumonia, acute respiratory distress syndrome (ARDS) or sepsis

Patients with COPD and CHF present an additional challenge and must be monitored (SoZo) and controlled

It has been reported that 96% of lab confirmed COVID-19 patients reported symptoms beyond 90 days

Hospital Benefits of a Relationship with a Dedicated Pulmonary Unit with Covid-19 capabilities

 

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SNF On-site Post-Covid Lung Program for COPD &CHF