SOUTH DAKOTA (KELO) — To the uninitiated, taking a sick nursing home resident to the hospital or emergency room may not seem like a big deal.
However, these movements can be demanding for older patients and facility staff, often requiring hooking and unhooking medical equipment, bundling patients in warm clothing, and placing them in wheelchairs or walkers. They may have to help loaded patients into vans or endure wait times to be seen by nurses or doctors. You don't always have access to your medical records.
“Going to the emergency room isn't good for everyone, but it's especially good for seniors,” said Josh Hofmeyer, CEO of Dow Rummel Village, a senior campus in Sioux Falls. That's not the point,” he said. “If you can avoid sending someone out (for medical care), it makes a huge difference.”
The best way to avoid stressful travel and provide more care within a senior living facility is to utilize telehealth services. That's why Hoffmeyer and others in South Dakota's long-term care industry are excited about two bills passed by the 2024 legislative session and subsequently signed by Gov. Kristi Noem.
Senate Bill 209 provides $5 million in grants to long-term care facilities to implement or expand telehealth services. The measure would be funded with funding from the American Rescue Plan Act, and the grant would be administered by the state Department of Health.
Another bill, Senate Bill 80, would give senior care providers $2 million for innovations that can “improve the quality of life and health of senior residents and support health care workers.” A subsidy will be provided. The fund would use state general fund money for grants administered by the Department of Human Services. Both measures stem from a summer 2023 legislative study session on the long-term care industry.
Telehealth providers, such as Sioux Falls-based Avel eCare, maintain a steady stream of nurses and doctors who are available on call at any time to provide care through an internet connection and video link. Long-term care residents have access to near-instant medical diagnosis and care at any time, with the assistance of in-room facility staff and healthcare professionals working remotely.
The Dow Ramel campus has been using telemedicine in the skilled nursing building for several years. A new grant program could allow the facility to expand telehealth services to other steps in the continuum of care at the campus, which houses about 315 residents.
“When you have a large population here on campus and you're dealing with their different medical needs, there's a lot that comes up that you have to deal with, so having access to telemedicine 24/7 really helps. It was really helpful,” Hoffmeyer said. “It's the wave of the future.”
Innovation grants for home health care
State Sen. Sidney Davis (R-Burbank), the lead sponsor of both health care subsidy bills, said the $2 million pool of innovation grants will help more people stay in nursing homes as they age. He said people may be able to stay in their homes longer instead of moving in. Davis told Newswatch that the innovation grant will help pay for more home monitoring and mobile diagnostic devices that patients can use at home and health care workers can use during home health visits. He said he may have to pay.
“We need to find alternative care models to keep patients safe and healthy at home for as long as possible, because home is where they want to be,” she says. “It’s beneficial for them and it’s cheaper for the state.”
Davis, a nurse anesthetist who is also a rancher, said a key element of the Innovation Grant Act is for recipients to monitor the effectiveness of new technology and equipment and to track what works and what doesn't. The government is requesting the state to submit a report on the matter. .
“Maybe some of these investments are worth continuing to make, and others are worth putting more money into in the future based on good results. We might even be able to invest in it,” she said. “We can complement each other and provide as much flexibility as possible to help providers best care for older adults.”
The field of telemedicine has been growing for decades, but it has made great strides during the COVID-19 pandemic, when in-person medical visits have been drastically reduced.
South Dakota is a leader in the telehealth industry, having launched Avel eCare in 1993 and significantly expanding its telehealth efforts offered by Sioux Falls-based Sanford Health.
The $350 million virtual care center will include a 60,000-square-foot facility under construction at the Sanford Sports Complex, just west of Sioux Falls Regional Airport.
Visual care is “worth a thousand words”
In the case of Avel eCare, subscribers install their own Internet connection and are provided with a mobile diagnostic cart with a video screen before paying a pre-arranged subscription fee for the service, which Avel's Senior Care Department said Medical Director Dr. Victoria Walker.
Walker said the subscription allows long-term care facilities to receive diagnosis and treatment plans from Abel's on-call doctors, nurses and pharmacists at any time. This video link also provides Avel practitioners with the patient's current medical records from hospital visits and within the long-term care facility.
Walker was recently working as Arvel's on-call doctor when a man in his 60s had suffered a stroke and was admitted to a nursing home where he was being fed through a tube. He was vomiting, in severe discomfort, and potentially in danger. The resident didn't want to go to the hospital, so Walker was able to use Abel's video link to diagnose him as severely dehydrated and in need of fluids, which stabilized him by giving him intravenous fluids and put him back on the feeding tube. can now be used.
“Seeing is believing, so when you can see someone and hear their story, you can quickly figure out what is needed in the situation and move things forward,” she said.
Walker said a new state grant program has enough funding to bring telehealth to more long-term care facilities and patients.
“I think that can make a pretty big difference. And once you have that infrastructure in place, it's like greasing the wheels a little bit so that when new gizmos come along, you can take advantage of them.” she said. “This is a proven approach to delivering quality care to seniors, and we are doing nothing but making it stronger and better.”
Supporting struggling industries
Mark Deak, executive director of the South Dakota Healthcare Association, which represents the state's long-term care industry, said the two sets of grants will provide much-needed support for residents and staff across struggling nursing homes. He said it would be. industry across the state.
Dieck testified before Congress in support of both subsidy programs, saying 17 long-term care facilities in South Dakota have closed over the past five years, largely due to financial difficulties and a lack of workers.
“Obviously, long-term care faces incredible challenges, some very unique challenges,” he says.
Deak said the state is providing significant support to the industry by raising Medicaid reimbursement rates paid to health care providers by 25% in 2023 and another 4% this year.
Subsidies are useful even in rural areas
Dieck said the new telehealth and innovation grants are expected to improve patient care and increase recruitment and retention of certified nursing assistants, who are the backbone of staffing in the long-term care industry.
By providing access to telemedicine and introducing other innovations in senior care, employees will no longer have to worry as much about keeping residents safe and healthy, and will be able to reduce the need for hospital and emergency transports. This reduces stress on employees as they no longer need to prepare as many patients as possible. Room, he said.
“The biggest benefit is that it makes it easier to treat residents on-site, which is a huge benefit,” Deak said.
Among the innovations being discussed are technologies that can help predict which nursing home patients are prone to falls, detect early signs of septic infections, and help develop nutritional plans for patients. He said there are.
Both grant programs could be particularly beneficial in rural areas of the state.
“Rural areas have very unique challenges due to their location in terms of attracting staff and providing the services they need,” Dieck said. “They don't have access to the medical support that they get in urban areas.”
He said the combined $7 million in grants won't solve all of the long-term care industry's challenges, but could provide a boost to facilities with significant financial hurdles.
“Certainly, the more the better, but I think it's a substantial move in the right direction,” Deke said. “I think it will make a huge difference.”