A long-term care skilled nursing facility in California recently touted regular testingTrusted Source as a way to identify, contain, and prevent SARS-CoV2 infections. Could their strategy better protect residents and staff at nursing homes across the country?
Deaths from the novel coronavirus in nursing homes account for more than half of all fatalities in 14 states, according to a Kaiser Family Foundation report out in May. During the same month, the Centers for Medicare & Medicaid Services (CMS) announced reopening guidelines, recommending daily screening and weekly testing for residents and staff.
Nursing homes have been hard hit by the COVID-19 pandemic, with many outbreaks spreading rapidly through a facility.
But one skilled nursing facility for veterans was able to identify, contain, and stop a COVID-19 outbreak, according to the CDC’s Morbidity and Mortality Weekly ReportTrusted Source published last week.
Initially, two patients at the facility tested positive on March 28. Over the next month, all 99 residents were tested, in addition to the 136 staff members. There were a total of 19 facility residents with COVID-19 and eight staff members with the disease. One facility resident died due to the disease.
In order to stop the disease from spreading further, the hospital based in Los Angeles started daily screening of symptoms among residents and staff. Additionally, everyone was tested weekly.
The tests caught a significant number of people who did not have symptoms of the disease.
Fourteen of the 19 facility residents who tested positive had no symptoms at the time of their test. Additionally, four of the eight staff members were initially asymptomatic.
While a significant number of patients tested positive in the initial month after the disease was detected, the staff were able to limit the spread of the disease after those initial weeks, stopping the outbreak from spreading.
While regular testing worked for this nursing home, it may not be feasible to repeat it in other nursing homes unless they have detected a case of COVID-19.
Testing the 4.4 million residents and staff of assisted living communities and nursing homes once would cost $672 million, according to an American Health Care Association/National Center for Assisted Living (AHCA/NCAL) analysis.
Christopher Laxton, executive director of the Society for Post-Acute and Long-Term Care Medicine, said the CMS guidance doesn’t address funding for testing. Residents may be covered if they have Medicare. But that doesn’t account for the cost of testing staff members.
This means the nursing home must absorb the cost of testing their employees
In the case of the facility for veterans, they may have more financial resources to cover testing costs, Laxton said. That’s not the case for many nursing homes, he added.
“It’s financially just very challenging,” he said.
Several states have committed to help cover testing fees in nursing facilities. Medicare provides some reimbursement for residents’ tests, and insurance carriers can help cover costs for workers. “But with varying policies, availability, and turnaround time, this creates a real challenge in combatting this virus and a real burden for providers,” an AHCA/NCAL spokesperson told Healthline.
“The cost of testing and who is going to cover and pay for the testing, particularly for staff, is a big issue,” Alice Bonner, PhD, director of strategic partnerships for the CAPABLE program at Johns Hopkins University, told Healthline.