>> SOMEONE GAVE, SOMEONE DONATED, SOMEONE LEFT A LEGACY.

THEY HAVE HELPED SHAPE RHODE ISLAND INTO THIS AMAZING PLACE WE CALL HOME.

THANK THEM BY LEAVING YOUR OWN LEGACY.

WE CAN HELP.

♪ PETER: WELCOME TO ANOTHER SEGMENT OF "IN ANOTHER OPINION."

THE SHOW IS A EDUCATION PROGRAM.

TODAY WE HAVE THE CEO OF RHODE ISLAND HEALTH CARE ASSOCIATION.

WELCOME ABOARD.

SCOTT: THANK YOU.

IT IS GREAT TO BE WITH YOU.

PETER: YOU AND I GO BACK A BIT.

WHEN WE FIRST MET, YOU ARE IN THE HEALTH CARE INDUSTRY.

AND YOU ARE BACK IN THE HEALTH CARE BUSINESS.

SCOTT: I WAS IN HEALTH INSURANCE FOR A WHILE.

AND THEN ON MY OWN FOR A WHILE.

I HAVE BEEN HEADING UP THE RHODE ISLAND HEALTH CARE ASSOCIATION.

WE ARE THE TRADE ASSOCIATION THAT REPRESENTS 80% OF NURSING HOMES IN RHODE ISLAND.

PETER: THIS IS ONE OF THE REASONS I WANT TO CHAT WITH YOU.

NURSING HOMES IN RHODE ISLAND HAVE TAKEN A BIG HIT.

BECAUSE OF THE PANDEMIC.

BECAUSE OF THAT, OTHER THINGS HAVE COME TO LIGHT.

TELL ME HOW THE ORGANIZATION WORKS.

SCOTT: WE HAVE BEEN FIGHTING THE VIRUS SINCE IT WAS FIRST SEEN IN THE STATE.

AS YOU KNOW, NO ONE COULD KEEP THE VIRUS FROM ENTERING THE STATE.

NO ONE COULD KEEP IT FROM ENTERING THE COUNTRY.

YOU HAVE HEARD CONGREGATE CARE SETTINGS ARE A SOURCE FOR THE VIRUS.

WE HAVE FOLKS LIVING UNDER ONE ROOF.

IN SPITE OF OUR BEST EFFORTS FOR INFECTION CONTROL, WE STILL DO A VERY GOOD JOB WITH THAT.

NATIONWIDE STUDIES HAVE SHOWN THAT IT IS A LEADING FACTOR TO SPREAD IN NURSING HOMES.

THERE HAS BEEN HIGH COMMUNITY SPREAD IN RHODE ISLAND.

PETER: HOW BIG IS YOUR ORGANIZATION AS IT RELATES TO NURSING HOMES?

SCOTT: WE HAVE 64 HOMES IN RHODE ISLAND.

WE DO HAVE ONE NONPROFIT MEMBER.

WHAT PEOPLE DON'T ALWAYS REALIZE IS THEY EMPLOY ABOUT 10,000 PEOPLE.

WHEN WE ARE ADVOCATING FOR OUR MEMBERS, SOME PEOPLE SAY, THERE ARE 10,000 RHODE ISLAND'S WHO WORK IN OUR HOMES.

THAT IS A BIG CONSTITUENCY.

WE HAVE RESIDENTS THAT WE CARE FOR ON A 25 -- 24 HOUR BASIS.

FOLKS STILL COME TO WORK EVERY DAY.

WHETHER OR NOT THERE IS AN OUTBREAK IN THE HOMES.

PEOPLE COME TO WORK EVERY DAY.

THEY REALLY DO CARE FOR THE RESIDENTS.

PETER: NURSING HOMES ARE SPECIAL ENTITIES.

AND THE PEOPLE WHO WORK IN THEM HAVE TO BE A CERTAIN TYPE.

I HAD THE PLEASURE WHEN I WAS WORKING WITH THE DEPARTMENT OF VETERANS AFFAIRS, I WAS THE ASSOCIATE DIRECTOR OF A MEDICAL FACILITY.

IT IS A TOUGH JOB.

PEOPLE ARE SICK, IN PAIN, THEY DON'T KNOW WHO THEY ARE.

YOU DID NOT HEAR MUCH ABOUT NURSING HOMES PRIOR TO THE VIRUS.

SCOTT: OUR STAFF IS AMAZING.

SOME OF OUR HOMES, WE DID ROUTINE TESTING EVERY WEEK.

SOME STAFF FELT FINE.

WE COULD NOT RISK HAVING THEM SPREAD THE POTENTIAL.

THEY WERE MOVED INTO CARE ROLES.

IT WAS ALL HANDS ON DECK.

PEOPLE ALL PITCHED IN.

WHAT WE FIND IS THAT MANY OF OUR STAFF HAD BEEN WITH US FOR YEARS.

PETER: LET ME ASK YOU A QUESTION.

DOES THAT THINK PLEAD MEDICAL >> THAT IS EVERYONE.

THEY ARE JUST AS IMPORTANT.

PETER: UNFORTUNATELY FOR ME, I SPENT A GOOD PART OF THE SUMMER AT A HOSPITAL.

I WAS BACK INTO THE EXPERIENCE.

WHEN I WAS IN THE HOSPITAL, I NOTICED THINGS I NOTICED THINGS THAT COULD BE IMPROVED.

PEOPLE WERE PUT INTO POSITIONS THEY WERE NOT READY FOR.

HOW MUCH DID NURSING HOMES IN YOUR ORGANIZATION HAVE TO DEAL WITH THAT?

SCOTT: IT WOULD DEPEND ON THE HOME AND THE STATUS OF THE OUTBREAK.

IT WAS VERY DIFFICULT TO FIND STAFF.

STAFFING HAS BEEN AN ISSUE BEFORE THE PANDEMIC.

THERE HAVE BEEN TIMES AT THE PAST WHERE YOU COULD FIND STAFF MEMBERS FROM A NEIGHBORING STATE THAT COULD COME IN AND WORK.

STAFFING WAS A CONCERN ALL AROUND THE COUNTRY.

IT WAS VERY DIFFICULT TO FIND QUALIFIED PEOPLE.

THE STATE OF RHODE ISLAND DID ALLOW THE AMERICAN HEALTH CARE ASSOCIATION TO HAVE AN EIGHT HOUR ONLINE TRAINING COURSE.

SO YOU COULD GET AN EMERGENCY LICENSE.

IT WAS ON-THE-JOB TRAINING.

THEY DID A WONDERFUL JOB.

RIGHT NOW WE ARE WORKING FOR THE STATE OF RHODE ISLAND TO GET THESE PEOPLE ON TEMPORARY LICENSES.

WE ARE WORKING WITH THE STATE TO HELP THEM LEARN LICENSES.

PETER: THAT MAKES SENSE.

IT IS PROBABLY AN UNDETERMINED BENEFIT.

PEOPLE WOULD NOT HAVE BEEN WORKING OTHERWISE.

SCOTT: THESE FOLKS TOOK THE COURSE BECAUSE THEY WANTED TO WORK.

THEY KNEW THEY NEEDED THE CARE.

WHEN I THINK OF THESE STAFF MEMBERS WHO LEFT THEIR FAMILIES AND CAME IN AND WORKED EIGHT HOUR SHIFTS, SOMETIMES THEY HAVE TO WORK OVERTIME, SOMETIMES THEY HAD TO WORK DOUBLES, TO CARE FOR THE RESIDENTS, THAT IS HEROIC.

PETER: EVERYONE IN HEALTH CARE HAS DONE WONDROUS THINGS DURING THIS PANDEMIC.

A LOT OF THE AMERICAN PEOPLE HAVE NOT STEPPED UP.

LET ME ASK ANOTHER QUESTION.

WERE THERE ANY NURSING HOMES THAT ACTUALLY CLOSED THEIR DOORS BECAUSE OF THE PANEMIC?

IF SO, ARE THEY BEING REPLACED?

SCOTT: A COUPLE OF HOMES HAVE CLOSED THEIR DOORS IN THE LAST YEAR.

THE PANDEMIC HAD SOMETHING TO DO WITH IT BUT IT WASN'T THE ONLY REASON.

THEY WERE A FIVE-STAR FACILITY.

THEY COULD NOT CONTINUE.

ANOTHER ANNOUNCED IT WILL BE CLOSING IN 60 DAYS.

PART OF THE REASON WAS MEDICAID FUNDING.

OUR FUNDING HAS BEEN CUT ALMOST EVERY YEAR SINCE 2012.

OUR COSTS HAVE GONE UP.

LOOKING AT SOME POTENTIAL LEGISLATION.

THE OWNERS SAID WE CANNOT KEEP IN OPERATION.

WE WILL HAVE TO CLOSE OUR DOORS.

IT WAS ANOTHER FIVE-STAR FACILITY.

IT IS UNFORTUNATE.

TO SAY IT WAS TOTALLY PANDEMIC RELATED, I CANNOT DO THAT.

PETER: THIS MAY SOUND INSENSITIVE, BUT I DON'T MEAN IT TO BE.

DO YOU THINK THEY WERE OVERDEVELOPED?

THEY PUT TOO MUCH INTO IT TOO QUICKLY?

SCOT: NOT AT ALL.

ALL OF OUR HOMES CONTINUE TO WORK FOR A TOP-QUALITY RATING.

IT IS JUST A MATTER OF, THERE IS A LAW THAT PASSED IN THIS STATE THAT SAID FUNDING NEEDS TO GO UP BY THE MEDICAID INFLATION INDEX.

IT HAS SOMETIMES BEEN CUT.

ACTUAL CUTS BELOW ZERO.

THAT IS WHY MEDICAID FUNDING IS SO IMPORTANT.

IT WAS JUST A COMBINATION OF THINGS.

IT WAS A 41 BED FACILITY.

BECAUSE OF THE NUMBER OF GUIDELINES ISSUED BY THE STATE, SEVERAL ROOMS HAD TO BE SET ASIDE FOR QUARANTINE ROOMS.

THE STATE REQUIRES US TO SET ASIDE ROOMS FOR PUTTING ON AND TAKING OFF PPE.

PETER: WERE THEY PRIVATE?

SCOTT: WHEN YOU SAY PRIVATE?

PRIVATELY OWNED.

MOST OF OUR RESIDENTS ARE NOT PRIVATE PAY.

IN THE PAST THAT HAS BEEN AN ARGUMENT FROM THE LEGISLATURE.

MEDICARE PAYS MORE THAN MEDICAID.

MEDICAID RESIDENTS KEEP GOING UP WHILE PRIVATE AND MEDICARE WE ARE MORE AND MORE RELIANT ON STATE FUNDING THROUGH MEDICAID.

PETER: IT IS INTERESTING THAT THERE IS A DIFFERENCE.

SCOTT: IT IS A VERY NOTABLE DIFFERENCE.

THAT IS WHY WE ARE ALWAYS ADVOCATING FOR STATE OFFICIALS.

PETER: DO YOU SPEND A LITTLE BIT OF TIME AT THE GENERAL ASSEMBLY?

SCOTT: QUITE A BIT.

THERE ARE MANY LEGISLATIVE LEADERS.

INVITE THEM IN FOR A VISIT.

NOBODY RAISES THEIR HAND AND SAYS THEY WANT TO DO THAT.

I ALWAYS SAID, STOP BY AND VISIT.

TALK TO THE ADMINISTRATORS.

TALK TO THE STAFF.

TALK TO THE RESIDENCE.

THE FOOD IS PRETTY GOOD.

SEE HOW THEY ARE DOING.

WATCH HOW THE STAFF IS INTERACTING WITH THEM.

THEY ARE SECOND FAMILY FOR THESE FOLKS.

PETER: THAT IS TRUE.

I'M SURE BECAUSE OF CHANGES IN THE LAW AND POLICY WITHIN THE THE JOB HAS CHANGED.

PEOPLE WERE CONCERNED WITH THAT.

THE BOTTOM LINE IS IT HAS CHANGED.

I HAVE KNOWN PEOPLE WHO HAVE PARENTS IN NURSING HOMES.

MY MOM PASSED AWAY IN A NURSING HOME.

IT'S WHEN YOU TALK TO FOLKS, THEY THINK ABOUT IT IN THOSE TERMS.

WHAT WOULD YOU LIKE IT TO BE LIKE?

TO WALK A MILE IN SOMEONE'S SHOES GETS SOME OF THOSE ANSWERS.

I WILL PUT YOU ON THE SPOT FOR A MINUTE.

DO YOU KNOW THE BREAKDOWN OF NURSING STAFF?

SCOTT: I DO NOT.

I KNOW A LOT OF THEM ARE MEN AND WOMEN OF COLOR.

MANY OF OUR HOMES HAVE EDUCATION PROGRAMS INSIDE THEIR FACILITIES.

IF SOMEONE COMES IN AND IS WORKING AS A DIETARY ASSISTANT, THEY CAN TAKE A COURSE AND BECOME A CERTIFIED NURSING ASSISTANT.

OR A COURSE TO BE A MED TECH.

THAT ALLOWS THEM TO DISPENSE MEDICATION.

WE WILL WORK WITH STAFF.

WE ARE VERY CONCERNED ABOUT CAREER PATHS.

WE KNOW HOW TOUGH IT IS TO KEEP GOOD STAFF.

IF THERE WASN'T GOOD CARE, WE WOULD GET ANOTHER PERSON TO COME IN.

WE WOULD LIKE TO SEE PEOPLE LOOK AT THIS AS A CAREER.

IF YOU TALK TO SOME OF OUR ADMINISTRATORS, THEY STARTED OUT IN DIETARY.

SOME OF THEM HAVE BECOME ADMINISTRATORS.

REGIONAL LEADERS.

THERE IS A GOOD CAREER PATH FOR PEOPLE WHO WANT IT.

I COULD NOT EVEN BEGIN TO GIVE A PERCENTAGE.

THERE IS A PIECE OF LEGISLATION IN THE STATE HOUSE.

SOME PEOPLE SAY WE ARE RACIST BECAUSE WE DO NOT PAY HER STAFF ENOUGH.

I WOULD OPPOSE THAT AND TAKE THE OPPOSITE SIDE 100%.

IT IS NOT ABOUT WHO IS WORKING.

IT IS ABOUT THE FACT THAT THESE PEOPLE DESERVE GREAT PAY.

THAT IS WHY WE ARE WORKING FOR GREATER MEDICAID REIMBURSEMENT.

SO WE CAN PAY ALL OF OUR STAFF A GREATER AMOUNT.

TO ACCUSE A NURSING HOME OF BEING RACIST IS WRONG.

IT IS A RED HERRING THAT TAKES AWAY FROM THE TRUE ARGUMENT.

THIS WOMAN IS A PERSON OF COLOR.

IT IS MORE OF A DISTRACTION.

PETER: HOW MANY OWNERS OF COLOR MIGHT THERE BE?

WOULD YOU SAY 10%?

5%?

SCOTT: IT WOULD BE UNDER 10%.

PETER: I HAVE NEVER DONE ANY RESEARCH.

BUT THAT IS INTERESTING.

WHEN YOU THINK OF SMALL BUSINESSES, YOU DON'T NECESSARILY THINK OF NURSING HOMES.

SCOTT: THAT IS A QUESTION THAT HAS COME UP RECENTLY.

IT IS CERTAINLY ONE OF OUR LOGGING POINTS.

SOMEONE ASSETS RECENTLY.

THERE ARE SO MANY CHAIN NURSING HOMES COMING INTO RHODE ISLAND.

SOME OF THEM ARE LOCALLY OWNED.

WE DO HAVE SOME CHAINS.

SOME FROM NEW YORK.

WE HAVE HAD NOTHING BUT POSITIVE RELATIONSHIPS WITH THOSE FOLKS.

WE HAVE HAD GOOD RESULTS AND GOOD EXPERIENCES.

PETER: IT IS ONE OF THOSE THINGS.

I AM NOT A CONSPIRACY THEORIST.

WHEN I WAS WORKING AND MANAGING A HOSPITAL, THEY DO A LOT OF GOOD.

A LOT OF THEM HAVE A RESPONSIBILITY TO THEMSELVES.

TO MAKE SURE THEY ARE PROVIDING THE CARE.

SCOTT: WE TALKED ABOUT THE DEVASTATION IN NURSING HOMES.

SHUTTING DOWN VISITATION.

THERE IS ALSO THE INCORRECT FEELING THAT SOME OF THESE PEOPLE DIED ALONE.

OUR HOMES ALLOW FOR COMPASSIONATE CARE VISITS.

WE WOULD ALLOW FAMILY MEMBERS AND.

THE IMAGE OF A RESIDENT DYING ALONE IS JUST NOT CORRECT.

THESE ARE ALL PEOPLE WHO HAVE RELATIONSHIPS WITH THEM.

THEY WOULD BE WITH THEM WHEN THEY WERE NEAR THE END OF THEIR LIFE.

THERE WAS ALWAYS SOMEONE THERE WITH THEM.

THEY WERE NOT ALONE.

PETER: THAT PART OF CARE IN MEDICAL FACILITIES OR NURSING HOMES OR HOSPITALS IS NOT TALKED ABOUT ENOUGH.

WE NEED MORE.

THERE IS A SHORTAGE.

IT HAS TO HAPPEN.

WE ARE GETTING DOWN FOR THE IN.

YOU PROVIDE A LOT OF EDUCATIONAL FACILITIES.

THERE IS NOT ENOUGH MARKETING.

I WAS NOT AWARE OF THIS.

SCOTT: THAT IS A GOOD POINT.

I KNOW A LOT OF OUR INDIVIDUAL HOMES TRY TO DO THAT.

TRY TO ENCOURAGE PEOPLE TO COME IN.

YOU CAN HAVE A CAREER HERE.

IT IS NOT JUST A MATTER OF MAKING WHATEVER THE STARTING PAY IS.

YOU CAN MOVE ON AND MOVE UP.

WE ENCOURAGE YOU TO DO THAT.

BUT YOU'RE RIGHT, IT WOULD NOT HURT.

I WILL MAKE A NOTE OF THAT.

WE WILL SEE WHAT WE CAN DO.

PETER: THEY DO IT ON THE SIDE AS A SECOND JOB.

THERE IS A DIRECT TRACK.

SCOTT: IF YOU KNOW FOLKS WHO ARE CNAS WHO DO THIS ON A PART-TIME BASIS, I ENCOURAGE THEM TO STOP BY ANY NURSING HOME IN THE NEIGHBORHOOD.

YOU WILL SEE A HELP WANTED SIGN.

THEY WILL BE VERY HAPPY TO SEE YOU TALK ABOUT EMPLOYMENT.

PETER: ANY LAST-MINUTE COMMENTS?

SCOTT: I APPRECIATE YOU HAVING ME ON.

IT IS ALWAYS GOOD TO CHAT WITH YOU.

NURSING HOMES TODAY ARE NOT WHAT PEOPLE THOUGHT OF 30 YEARS AGO.

WE PROVIDE CARE.

WE PROVIDE FOOD.

ACTIVITIES.

IT IS QUITE AN OPERATION.

PETER: WE HAVE RUN OUT OF TIME.

I WOULD LIKE TO THANK YOU FOR BEING ON THE SHOW TODAY.

AND YOU THE VIEWERS FOR TUNING IN TO ANOTHER SEGMENT OF "IN ANOTHER OPINION."

I WOULD LIKE TO THANK PBS FOR MAKING THE SHOW POSSIBLE.

GIVE US YOUR OPINION ON FACEBOOK OR TWITTER.

HAVE A GREAT DAY.

[CAPTIONING PERFORMED BY THE NATIONAL CAPTIONING INSTITUTE, WHICH IS RESPONSIBLE FOR ITS CAPTION CONTENT AND ACCURACY.

VISIT NCICAP.ORG] ♪