QUALITY IMPROVEMENT
Building the bridges The obstacles are being overcome by several providers, including Chelsea Senior Living, Sunrise Senior Living, and Country Mead- ows Retirement Communities, through partnership with federal programs and other organizations. When Country Meadows was offered
treatments through a relationship with Penn State University, “we took the opportunity and ran with it,” says Dr. John Hopkins, DO, Country Meadows corporate medical director and president and founder of CCS Healthcare. “Because of the large number of infec-
tions at that time, in December and January, we were doing sometimes 10 a day, for three days in a row…. it’s been a wonder drug of sorts for us.” The provider kept a traveling team of two
nurses and an advanced practice clinician on call, paying a retainer through grant funding. They expanded the program, training nurses in its skilled nursing facility to administer treatments. Country Mead- ows itself has a strong clinical support team; recognizing that demographics were leading to rising acuity in senior living, it had al- ready begun a strategy to build capability and leadership to meet such needs. “The families, in the beginning, had a lot
of questions,” says Meredith Mills, MHA, PCHA, senior vice president and chief operating officer at Country Meadows. “So over time, we’ve transferred that task from the medical teams to the executive directors, providing them with a FAQ list.” Sending information about the positive
results to residents and families also made a big difference. Staff and families alike were particularly heartened by the recoveries and “thriving” residents in memory care, where physical illness can precipitate a steep decline. “I think something we do quite well is
partner very closely with the medical en- tities around us and coordinate resources. I encourage other senior living providers to not think they can do it all on their own, because I do think it seems daunting,” says Mills. “Like Dr. Hopkins says, leverage your resources.”
26 SENIOR LIVING EXECUTIVE MAY/JUNE 2021
It takes a network Indispensable to many mAb efforts was the work from two mAb champions: the Na- tional Home Infusion Association (NHIA) and the U.S. Health and Human Services Department, particularly Project ECHO for monoclonal antibodies. To get more treatments to more people,
HHS and Dr. David Wong, Chief Medi- cal Officer in the HHS Office of Minority Health, developed the SPEED program, which targeted long-term care first, provid- ing the antibodies to pharmacies, and help- ing to get infusion nurses. Also through this program, a coalition including Argentum and five other associations for older adults have established the Long-Term Care In- fusion Support Activity, or LISA, through which communities and neighborhoods can tap into specifically trained and vetted Med- ical Reserve Corps members for infusions. For NHIA, helping get the lifesaving
treatments out was a passion project on the part of its CEO, Connie Sullivan, BSPharm, and senior director of clinical services Ryan Garst, PharmD, MBA, BCSCP. Home and specialty infusion pharmacies can provide the skills and experience to per-
form a variety of infusions, from hydration to specialized medications such as mAbs, as well as the knowledge to coordinate care across a multi-disciplinary care team. As Garst says, home infusion providers are a “one-stop shop,” and used to working with a variety of patients and physicians to provide care. In partnership with HHS and organiza-
tions such as Argentum, they got the word out about what they could do: provide a turnkey solution with the speed and exper- tise necessary to make the treatments work. In addition to the safe prep, infusions, and monitoring, they help educate staff and families and bill for reimbursement. As Argentum’s vice president of quality
improvement John Schulte puts it: “This program checks all the boxes.” The participants of the NHIA SPEED
program provided monoclonal antibody therapy while continuing to service their current patients to keep them at home and out of the hospitals, which provided relief to health systems. NHIA is still working to increase reimbursement for these therapies in the outpatient setting, which will allow for even greater access to these efficacious products.
RESOURCES
• Information on the FDA emergency use authorization for monoclonal antibodies for the treatment of COVID-19 is at
fda.gov under News & Events.
• The Long-Term Care Infusion Support Activity (LISA) is a new pathway to request staff support for monoclonal antibody infusions in assisted living and long-term care. This grassroots opportunity facilitates the use of interested and qualified Medical Reserve Corps (MRC) volunteers to provide staff support for administering COVID-19 monoclonal antibody infusions. LISA is a collaborative initiative designed and supported by six national associations, including Argentum, that have united to form the Coalition to Advance Community-Based Solutions for COVID-19. The programs’ goals are to reduce hospitalizations, preserve U.S. healthcare system capacity, and protect America’s seniors against COVID-19:
argentum.org/coronavirustoolkit
• The COVID-19 Treatment Guidelines from NIH include updated information on monoclonal antibody treatment:
covid19treatmentguidelines.nih.gov
• Argentum Members only: Access the webinar, Monoclonal Antibody Treatments Briefing, from April 7, at
argentum.org/covid19webinars
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