Headwinds stemming from a lack of access to senior housing facilities during the pandemic took a toll on hospice providers’ margins during 2020, but that market is expected to rebound as the year progresses. The pace of that change remains uncertain, according to Keven McNamara, president and CEO of Chemed Corp. (NYSE: CHE). Chemed is the parent company of Vitas Healthcare, at the Oppenheimer conference.
Disruption in the larger health care and aging services space adversely impacted VITAS during the course of the past year. This is particularly due to difficulty accessing patients in nursing homes, assisted living and senior housing operations, as occupancy drops due to the pandemic.
“Senior housing is an important referral source for us. It gives us the longer stay patients, who are much more likely to come from senior housing than from a hospital discharge plan.,” McNamara said at the Oppenheimer 31st Annual Healthcare Conference. “The first thing that has happened is opening up the nursing homes, allowing us to provide good service that makes hospice seem attractive and also be available to talk to the families and the potential patients.”
While VITAS saw two sequential quarters of strong admissions growth during the latter half of last year, average daily census dropped 2.8% during Q4. The company attributes much of this reduction to issues in the senior housing sector, including nursing homes and assisted living.
The U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Centers for Disease Control and Prevention (CDC), recently revised their previous guidance for visitors accessing nursing homes, including service providers such as hospices. The availability of vaccines was a key factor in the update.
The agencies now indicate that facilities can allow ”responsible indoor visitation” at all times and for all residents, regardless of vaccination status of the resident or visitor, unless certain scenarios arise that would limit visitation.
The new guidance specifically indicates that facilities should permit “compassionate care” visits at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak. The agency defines compassionate care to include visits for a resident whose health has sharply declined or is experiencing a significant change in circumstances
“We’re going to return to normalization and senior housing. Our culture is predicated upon quality senior housing for our elderly, and we’ll return to \n the second half for 2021,” Walker said. “The only debate is whether it is going to be V-shaped or is it going to be a tsunami.”
The rate of COVID-19 infections is declining among residents of long term care facilities, largely due to vaccinations. This is good news for hospice providers who have been struggling to gain access to facility-bound patients during the pandemic.
Long term care facilities have been among the hardest hit by the killer virus. To date, more than 640,000 of their residents have contracted the novel coronavirus, leading to 130,000 deaths, according to the U.S. Centers for Disease Control & Prevention.
Accessing patients in facilities has been a top concern for hospice leaders during 2020 and 2021, as nursing homes have imposed strict limitations as to who may enter due to fears of spreading the virus. While in many cases hospice nurses have been allowed to come in, many patients have not been able to receive the full benefit of the interdisciplinary care model.
Recent data from the U.S. Centers for Medicare & Medicaid Services (CMS) show that numbers are starting to come down as more residents become vaccinated. During the week of Jan. 17, about 17,500 new infections occurred in nursing homes. Just one month earlier around Dec. 20, weekly cases exceeded 32,000.
“There was an effect of the pandemic in the [United States]. We’re seeing that now with [patient] census,” Walker said. “I think we’ll be on track for improved conditions. We’re watching this very carefully.”