In light of the COVID-19 emergency, adult day centers across the country were forced to temporarily shut down or operate at limited capacity. Now, adult day providers are navigating how to safely open back up again.

Broadly, adult day centers give seniors access to community-based social and health services. This can include recreational activities, meals, medical services, therapeutic activities and personal care.

Over the years, adult day services have become a popular way to provide care and companionship for seniors. In fact, there are over 5,000 adult day centers serving more than 260,000 individuals across the U.S., according to the National Adult Day Services Association.

Despite this growing popularity, adult day providers were not the recipients of major funding from the federal government when the public health emergency hit. Combined with revenue loss from limited capacity or shutdowns, that lack of government relief took a toll on providers.

In response, LeadingAge, the Washington, D.C.-based association of nonprofit providers of aging services, sprung into action. In November, the advocacy organization penned a letter to Congress urging lawmakers to provide relief.

Since then, there has been some progress: specifically, the American Rescue Plan’s allocation of an estimated $13 billion to home- and community-based services, through the 10% FMAP bump, according to Brendan Flinn, the director of home- and community-based services at LeadingAge.

“With the guidance for that coming out and anticipating the state will start to receive and use those funds soon — the investment had been made,” he told Home Health Care News. “We’re looking forward to seeing all the different things that states will do to shore up adult day services providers, and make sure providers of home- and community-based services have the resources they need to deliver care.”

When Rogerson Communities’ adult day programs originally closed its doors at the end of March 2020, there were many considerations the organization had to take into account in order to ensure seniors still received care, according to Dr. Brandi Derr, director of programs at Rogerson Communities.

“The clinical team and leadership team really had to come together and start thinking about who can be at home with remote support from us and … who would really suffer from the day programs closing,” she told HHCN. “We put a lot of our care planning focus on the folks we knew would have a tough time being at home without a place to physically come in to receive services. We tried to create more wraparound services for them.”

This meant services ranging from in-home rehab to meal packages.

Boston, Massachusetts-based Rogerson Communities offers senior housing and health care services. The company operates three adult day health programs and one adult day social program that serve about 325 seniors annually.

As an organization, Rogerson Communities’ offers the full scope of adult day programming. Rogerson Communities’ staff includes on-site nurses, on-site certified nursing assistants, therapeutic activity coordinators, kitchen coordinators and social services professionals, in addition to a transportation team that enables the company to provide seniors rides to and from home.

Rogerson Communities began re-opening its adult day centers — at 50% census capacity — last August. For context, pre-COVID, the organizations’ Roslindale, Massachusetts, site had the capacity for 90 participants per day.

“We did it in phases,” Derr said. “We started with a soft opening with about five to 10 participants, and then we just kept gradually increasing week by week, just to build ourselves up and to get our staffing back in order.”

In order to re-open safely, Rogerson Communities went through its entire adult day program and completely redesigned the structure to adhere to social distancing precautions.

“We went from these large communal rooms to these sort of pod-programming spaces,” Derr said. “We set tables 6 feet apart, we had plexiglas dividers, and we changed our food delivery model, … paying more to have meals that are pre-packed individually. Then we had to review with every single incoming participant what the new normal would be.”

As adult day centers across the country continue to re-open, providers will need to stay on top of the different requirements and regulations that are happening at the state level, according to Flinn.

“Different states have different rules in place and different timetables,” he said. “What we are seeing is that adult day providers are doing a really good job in response to all of those different rules, requirements, guidance, etc. Providers have really demonstrated their ability to provide care to the older adults they serve in a way that is safe — whether that is universal masking policies, helping people get vaccinated or other measures within their centers.”

While many providers have been able to re-open their doors, one of the lasting impacts of the public health emergency will be that it drove many adult day centers to close their doors permanently.

“If fewer providers are operating community services, [it means] fewer people are able to receive community services, and that creates a whole slew of issues, particularly as we look at the demographics,” Flinn said. “This is a country that has a growing aging population. Adult day is a critical piece of the long-term services and supports puzzle.”

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