VIEWPOINT: Understanding the Complexities of Long-Term Care

If your business closed today and was gone tomorrow, would Central New York miss it? What would the impact be on our community? An article in the Harvard Business Review I recently read opened with a similar question. Loretto, as the fourth-largest health-care provider in the region, is deeply ingrained in the fabric of our community. We employ 2,500 individuals who deliver care to about 10,000 people of all ages, income levels, and care needs in Onondaga and Cayuga counties. If we closed our doors overnight, the individuals who rely on us would feel the impact. However, the second question really gave me pause. In addition to providing jobs and care, Loretto also plays an integral role in the regional health-care continuum. Chances are you, or someone you know has experienced lengthy wait times in our local hospitals. If you haven’t, chances are you have read about it. William Paolo, chief of emergency medicine at Upstate University Hospital, was recently quoted by Syracuse.com, saying the only way to reduce ER wait times is to increase the number of available beds upstairs. It’s simple math — if there are more people coming into the ER than beds available in the hospital, you will wait either in the waiting room or in a “boarding” area. While seemingly independent from long-term care, these waiting times are connected to our work at Loretto. Over the past several years, we have taken risks to embrace and pursue our community-focused mission — to be a family of exceptional people who care for and about each other. • When we experienced the COVID-19 pandemic, our swift actions, such as setting up a COVID facility and providing training for the National Guard, directly benefited the community by helping to decant patients from the hospitals. • When there was a health-care worker shortage, our initiatives, such as providing wage increases, on-the-job education opportunities, and new work schedules, directly improved the health-care services in the community. • When the needs of the short-term rehab patients in our community changed, our investment in our restorative care unit (RCU) directly addressed those needs and made room in local hospitals. The long-term care industry has been challenged to get creative and innovate when it comes to care and funding. We have accepted that challenge — anticipating community needs, studying trends, and making meaningful changes. As a result, our facilities no longer resemble nursing homes from 10 or 15 years ago. Patients are younger and/or more complex, and they are coming from a greater distance. We recently had patients from Rochester complete rehab at one of our facilities. The restorative care unit (RCU) looks like a hospital floor, providing advanced wound care, treating patients with LVAD, and other highly complex care as a part of short-term rehab. As we continue to anticipate needs and observe trends, an effort to explore dialysis is underway to relieve our local hospitals. We continue to evaluate our on-the-job education and training programs, empowering employees to provide a new level of care — and earn more. While the demands on long-term care facilities to innovate caring for our most vulnerable populations have become a critical part of our overall regional health-care network, it comes amid a funding crisis, explosive anticipated growth from Micron, and an increase in the aging population known as the “Silver Tsunami.” If community members are having to wait for health care now, how much more will they have to wait in the future? In CenterState CEO’s 2024 Economic Forecast for Central New York, Participants were asked to identify the biggest economic factors impacting Central New York businesses, one of which was “pressures on the health care delivery system as the population of the region increases.” I share that concern. The outcomes of the most recently passed New York State budget continue to have significant financial impacts on our already strained nonprofit long-term care system. When you consider the limited rate increase that will not cover this year’s cost of living index, combined with the 10-percent cut to support of facilities and the CMI freeze — how we are paid for care — Loretto will experience a nearly $1.2 million loss in planned revenue in just one year. As the region’s leading provider of services for the Medicaid and underserved populations in Onondaga and Cayuga counties, as 75 percent of Loretto residents are supported by Medicaid, the impacts of this budget shortfall are long-reaching. As a local leader in this industry, my aspirations are to continue innovating solutions, providing a high level of care to our patients, educating and empowering employees, and supporting hospitals. However, the reality is that this business of aging is still a business, and there is a limit to what Loretto and other long-term care facilities can do without financial support. Many have been forced to close their doors or sell to out-of-state systems due to financial limitations. As I consider Loretto’s impact on our community, I look ahead with realistic optimism. Loretto’s leadership and employees are truly a family of exceptional people, and we have accomplished much together. However, stabilizing a business when funding opportunities are decreasing, and community needs are increasing is challenging. We must continue to take risks and embrace creativity and innovation to survive. I am reminded of an observation made by John F. Kennedy: “The Chinese use two brush strokes to write the word ‘crisis.’ One brush stroke stands for danger; the other for opportunity.” The opportunity is to deliver high-quality care in new ways. The danger is that our most vulnerable seniors will be left behind.              

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Kimberly Townsend, Ph.D. is president and CEO of Loretto and author of “Lifecircle Leadership” and “Lessons in Lifecircle Leadership.” For more information about Townsend, visit: DrKimberlyTownsend.com and LorettoCNY.org.