States Still Trying to Get a Handle on Virus Testing in Nursing Homes

A resident and visitors at the Hebrew Rehabilitation Center, on June 10, 2020, in Boston.

A resident and visitors at the Hebrew Rehabilitation Center, on June 10, 2020, in Boston. AP Photo/Elise Amendola

 

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Oregon this week became one of the latest states to move ahead with a testing initiative. People have been getting sick from the coronavirus in long-term care facilities at disproportionate rates.

Oregon will adopt a plan to test all residents and staff at nursing homes and other long-term care facilities on a regular basis for the coronavirus, Gov. Kate Brown said Tuesday. It marks one of the latest state efforts to tackle testing at the facilities.

Nursing homes and other long-term care sites have proven to be hotbeds for coronavirus outbreaks. But getting widespread testing programs set up at the facilities has been complicated by costs, limited testing supplies and inconsistent strategies around the country.

The Centers for Medicare and Medicaid Services issued a report last week that found among roughly 13,600 nursing homes reporting data nationwide there had been about 95,000 confirmed coronavirus cases and nearly 32,000 virus-related deaths through May 31.

A total of about 1.9 million coronavirus cases and 112,000 deaths had been reported across the U.S. as of Wednesday.

Several states have launched investigations into whether nursing homes could have done more to contain the spread of the virus. Other critics have raised questions about whether states stayed on top of what was happening in the facilities as the pandemic worsened.

The virus’ toll in long-term care facilities extends beyond the elderly. ProPublica Illinois reported last month that more than 1 in 5 people living in state-operated centers for adults with cognitive or behavioral disabilities had tested positive for the coronavirus.

State and federal authorities took action to restrict visitors at long-term care facilities earlier on in the public health crisis, but workers still have to come and go to keep the facilities operating.

In Oregon, Brown said a pair of state agencies would issue further details about the state’s plan for testing later this week, adding that facilities considered to be higher risk would be the priority.

“Expanding testing is an essential first step that will allow us to examine how visitation policies can be safely and incrementally eased,” the governor said in a statement.

Oregon so far hasn’t been an epicenter for the virus. On Wednesday, the state was reporting 5,060 coronavirus cases and 169 deaths.

State figures issued on June 10 for the week ending June 7 showed that during that week alone at least 201 cases and 17 deaths had been linked to senior living communities and other “congregate” settings, other than prisons or jails.

States that have experienced bigger outbreaks have already adopted various statewide testing mandates for long-term care facilities. 

New Jersey Health Commissioner Judith Persichilli issued a directive about a month ago that required all long-term care facilities there to implement testing for staff and residents by May 26.

The state has seen coronavirus outbreaks in at least 550 long-term care facilities, with around 23,225 cases among residents and about 11,500 cases among staff, according to the state. The state has also confirmed at least 5,471 long-term care resident and staff deaths tied to the virus.

California state officials also recently issued recommendations for universal coronavirus testing at nursing home facilities. 

But The Los Angeles Times reported that critics and industry groups said the state set guidelines leaving responsibility for testing with counties and nursing homes, which could lead to more of a hodgepodge approach to how tests are carried out and paid for.

Questions about who should pay for the tests have percolated for weeks now. A trade group that represents assisted living facilities has estimated that testing could cost over a $1 billion a month nationwide, and said these costs would be unsustainable for their industry.

Groups representing long-term care facilities in New York cited costs and other burdens in a letter this week to state officials, asking that the state end a requirement that calls for workers at the facilities to be tested twice a week.

A spokesperson for the Oregon Health Authority in an email on Wednesday said they could not answer questions at this point about who would pay for the testing initiative in the state, but reiterated that more details about the program would be released in the coming days.

Brown also sent a letter on Tuesday to Trump administration officials saying that the state’s plans for testing in long-term care facilities were being hampered by a lack of supplies, and requesting that the federal government increase Oregon's allotment of these items.

Editor's note: This story was updated to clarify information about case and death figures at Oregon congregate living facilities.

Bill Lucia is a senior reporter for Route Fifty and is based in Olympia, Washington.

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