If there were a “game-changing medication” available to senior living providers to help fight off COVID-19 and potentially avoid a hospital trip for residents, would you use it?
Lisa Torchia, vice president of clinical and support services for Pennsylvania-based Country Meadows Retirement Communities, asks, “How can you not?”
Monoclonal antibody (mAb) COVID-19 infusion treatments were authorized by the Food and Drug Administration for emergency use against COVID-19 in November. When administered early in the course of infection, the outpatient infusions can impede disease progression and prevent hospitalization.
The Centers for Medicare & Medicaid Services announced in November that coverage for the treatments is available to beneficiaries who live across a variety of healthcare settings, including assisted living, at no cost during the public health emergency.
But staffing shortages, access to treatments, unfamiliarity and overwhelming clinical demands are challenges that are preventing some senior living communities from jumping on the bandwagon to administer these treatments.
“Everybody is focused on the vaccines, and has been since November. The industry is busy, always, but even more so during COVID,” Argentum Vice President of Quality Improvement John Schulte said. “People just haven’t had as much time to get the information on these treatments.”
Success
Country Meadows has administered mAb treatments to more than 100 residents — mostly assisted living, personal care and independent living residents — since late December, with a 97% success rate.
Torchia called it a “remarkable outcome.”
“To us, we want to do everything possible to have our residents survive,” she said. “When there’s a treatment available to them, we want to bring it to them.”
Country Meadows is accessing mAb treatments in two ways: through its partnership with Penn State Health and through its long-term care pharmacy, Diamond Pharmacy Services. County Meadows Medical Director John Hopkins, D.O., president and founder of CCS Healthcare, contracts with a team of outside nurses to administer the infusions and monitor residents.
Chelsea Senior Living, based in Fanwood, NJ, also is making on-site mAb treatments available to its New Jersey and New York assisted living residents through a partnership with CCS Healthcare. Although Chelsea Senior Living has worked to minimize infections in its communities, it is still dealing with isolated outbreaks.
“The impact the monoclonal antibody has had on our patients has been nothing short of remarkable,” Hopkins said. “This is a game-changing medication in the fight against COVID. It truly saves lives.”
Pat Banta, BSN/MA, regional director of health services for Chelsea Senior Living, said that Barrington, NJ-based CCS Healthcare provides the infusions and monitoring to its assisted living residents who have confirmed COVID-19 infections and fit the criteria for therapy.
“It reduces the likelihood of developing severe illness requiring the need for hospitalization, can provide short-term immunity and reduces the risk of infection transmission,” Banta said.
Access
To help providers, the U.S. Department of Health and Human Services created the SPEED (Special Projects for Equitable and Efficient Distribution) pilot program to provide mAbs directly to pharmacies serving long-term care communities.
Schulte said the SPEED program ensures that long-term care facilities have access to the treatments, and it connects people with third-party providers who specialize in the infusion treatments.
The National Home Infusion Association can connect operators with those third-party home infusion providers who can access and administer Bamlanivimab mAb therapy through the SPEED program. NHIA also provides a map and a provider list showing the location of infusion providers around the country.
Through the SPEED program, NHIA members prep for and provide mAb treatments. They also handle post-treatment monitoring, the consent process and billing for communities.
“People in assisted living, in particular, are busy and may not have the expertise to provide these infusion treatments,” Schulte said. “These third parties can really, once you find a party to work with, they can secure consent from patients, administer the treatment, monitor for adverse reactions and address those if there are any reactions. They use their own PPE and they can do treatments for a small group at once.”
The University of New Mexico School of Medicine provides information on mAb treatments through its Project ECHO website, including a resource library that includes a section specific to long-term care communities. Resources include a facility checklist, prescriber order forms, consent forms and fact sheets.
Staffing help
Argentum also is supporting the proposed Long-Term Care Infusion Nurse Corps, or LINC, through which volunteer Medical Reserve Corps nurses would administer mAb treatments in long-term care. The proposal still is under review by CMS but would provide additional, qualified personnel to help assisted living communities and other providers to provide the infusions.
Schulte said that Argentum has been sharing information through newsletters, webinars, roundtables and conversations with communities.
For providers considering adding the treatment to their COVID-19 toolbox, Torchia has this advice: “You just have to make your mind up that you’re going to do something and then find your path.”
