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Kentucky Lawmakers Discuss Coronavirus Impact On Long-Term Care

Care for old people in nursing homes accounts for 21 percent of Medicaid's budget, even though they are just 9 percent of people covered by Medicaid.
Getty Images/Picture Press RM
Care for old people in nursing homes accounts for 21 percent of Medicaid's budget, even though they are just 9 percent of people covered by Medicaid.

Coronavirus continues to be deadly in Kentucky’s long-term care facilities like nursing homes, and is especially dangerous for residents suffering from Alzheimer’s disease and other forms of dementia, lawmakers were told Wednesday.

According to the Alzheimer’s Association of Greater Kentucky, people with dementia make up 48% of residents in nursing homes and 42% of residents in other assisted living facilities.

During a legislative hearing on Wednesday, Mackenzie Wallace Longoria, the group’s public policy director, said that more than 95% of people with dementia have an additional chronic health condition that makes them vulnerable to the virus.

“It can be very difficult to explain to an individual with this disease why they can’t touch their face, why they can’t resume congregate activities, to understand why staff and caregivers are wearing masks and other pieces of protective equipment,” Wallace said.

Coronavirus can spread rapidly through a long-term care facility and is especially deadly because of residents’ health conditions and age.

There have been 525 coronavirus-related deaths in Kentucky’s long-term care facilities, 58% of the death total in the state.

Kentucky stopped all visitations at long-term care facilities after the pandemic began in March, but they were allowed to resume over the summer with social distancing, sanitation and other precautions.

Longoria said that social isolation during the pandemic is especially hard for people suffering from dementia.

“Everyone is sort of dealing with this back and forth of what is worse: our loved ones dying of COVID-19 or experiencing rapid, cognitive decline leading to their death,” Longoria said.

Kentucky created long-term care “strike teams” that are deployed to facilities that have staff with coronavirus symptoms. The state also provides funding for surveilling testing of staff and residents.

But Betsy Johnson, president of the Kentucky Association of Health Care Facilities, said that facilities have struggled to respond to the virus, and that funding from the state hasn’t been adequate.

Johnson said emergency Medicaid funding that provided $270 for every long-term resident who had contracted coronavirus wasn’t enough.

“We are grateful for this funding, but we found it a little problematic,” Johnson said. “Not everybody in a facility is Medicaid eligible, a lot of them are Medicare or private pay. So it really wasn’t providing the necessary funding in arming ourselves to fight off COVID-19.”

Johnson said surrounding states are doing a better job of propping up long-term care facilities during the pandemic.

Sen. Ralph Alvarado, a Republican from Winchester, criticized the Beshear administration’s response as “one-sized fits all.”

“The governor talks at people every day, but he won’t respond to their communications. So those people contact us as legislators. And they have legitimate questions and concerns,” Alvarado said.

Adam Mather, inspector general for Kentucky’s Cabinet for Health and Family Services, defended the state’s long-term care response. Mather said Kentucky has a very robust program, calling it "best-in-class" among other states.