COVID-19 Updates

One-Time COVID-19 Testing Of Each Nursing Home Resident, Staff Member In US Would Cost $440 Million

Skilled Nursing News (5/20, Spanko) reports, “The nation’s largest organization representing nursing homes on Wednesday pegged the one-time cost of testing each resident and staff member in the United States at $440 million, arguing that substantially more funding for long-term care will be necessary to meet more stringent testing mandates.” To arrive at that amount, the American Health Care Association added “up the more than 1.3 million nursing home residents and 1.6 million staffers across the country, then” multiplied “by an average per-test cost of $150 apiece.” The “number also does not include residents and workers at other types of senior living and care facilities, such as assisted living and memory care properties, AHCA observed.”

        Florida Politics (5/20, Gancarski) reports, “If left to private operators to bear the burden, it would be ‘unsustainable,’ according to a study released Wednesday by the American Health Care Association and National Center of Assisted Living.” In addition, “one time testing is not enough, asserts CEO Mark Parkinson.”

        The Reading (PA) Eagle (5/20, 168K) reports, “Doing weekly tests would cost more than $1.75 billion nationally.” AHCA/NCAL president and CEO Mark Parkinson said, “For months now, we have been advocating for expanded and priority testing in nursing homes to protect our residents and caregivers, but this is a significant undertaking and cost for nursing homes to shoulder on their own. … That’s why we have asked the U.S. Department of Health and Human Services to grant our request for a $10 billion emergency relief to help fund expedited testing and the additional staffing needed to respond to this unprecedented health crisis.”

        WHTM-TV Harrisburg, PA (5/20, 35K) reports, “The American Health Care Association and National Center of Assisted Living are suggesting a formula for the requested $10 billion funds.” The associations “say over the next four months, payments should be based on the size of the facility and whether it has COVID-19 positive residents.”

        WJAC-TV Johnstown, PA (5/20, News, 67K) reports, “The American Health Care Association and The National Center for Assisted Living provided a state by state breakdown of what it would cost to test every nursing home resident and staff member once.”

        McKnight’s Long Term Care News (5/21) reports, “California, New York, Texas, Florida and Ohio are among the states where one-time, universal testing would be most expensive, according to” AHCA/NCAL. The testing “effort would cost about $36.3 million in California; $33.9 million in New York; $29 million in Texas; $25.3 million in Florida; and $24.9 million in Ohio.”

AHCA/NCAL Answers Legal, Reimbursement Questions On Changes Related To COVID-19

Provider Magazine (5/20, Connole, 151K) reports “the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) has issued answers to the frequently asked questions that long term care providers have concerning reimbursement and legal changes resulting from the coronavirus (COVID-19).” Some of the included issues relate to Medicare testing coverage, the CARES Act, and resident/employee testing refusals. The association “said for more information, providers can review the reimbursement and legal section of the association’s Preparing for Widespread Testing in LTC Guidance.”

NIC Provides Data Showing COVID-19’s Impact On SNF Occupancy

Provider Magazine (5/20, Connole, 151K) reports, “Fresh data released by the National Investment Center for Seniors Housing & Care (NIC) offered the first glimpse of the negative impact the coronavirus (COVID-19) has had on seniors housing and, more specifically, skilled nursing facility (SNF) occupancy.” Specifically, “according to the NIC MAP Data Service for April, the first full month of the COVID-19 pandemic in the United States resulted in seniors housing occupancy sliding by a 1.1 percentage point decrease to 88.7 percent, while SNF occupancy was down 2.2 percentage points to 84.7 percent.” These “data are featured in NIC’s Intra-Quarterly Snapshot, a new monthly publication developed from NIC MAP data to increase transparency about seniors housing and care during an unprecedented time for the sector, NIC said.”

New York City Offers Coronavirus Testing At Nursing Homes

POLITICO New York (5/20) reports that “New York City will offer free coronavirus tests for all city nursing homes, and will provide staff to fill in for workers who test positive, Mayor Bill de Blasio said Wednesday.” Politico says “the city plans to make tests available for 169 homes located in the five boroughs, and expects to do up to 3,000 tests a day there.”

        The AP (5/20) reports that “nursing home industry groups and a residents’ advocate commended the city’s testing initiative, though it didn’t resolve all their concerns about staffing and the costs of testing.” Specifically, New York State Health Facilities Association/New York State Center for Assisted Living president Stephen Hanse “said Wednesday they applaud the moves the state and city made this week.” However, he added, “New York’s nursing home industry will need more funding and support to meet the national and state testing guidelines.”

Minnesota Department Of Health Suggests Delaying Implementation Of Rules To Increase Assisted Living Community Oversight

McKnight’s Senior Living (5/20, Bonvissuto) reports, “Citing an urgent need to focus on fighting the COVID-19 pandemic, the Minnesota Department of Health has proposed delaying the implementation of new rules that would increase oversight of assisted living communities in the state.” Care Providers of Minnesota president and CEO Patti Cullen said that “reality is reality” and that “several areas remain to be addressed before the planned tiered licensing is implemented.” Cullen told McKnight’s Senior Living, “We haven’t been participating in rulemaking since we declared a state of emergency here two months ago. … The clock is ticking. We just didn’t think it can be done in a way that reflects true stakeholder input from all of the stakeholders.” Cullen added, “We pledge to continue discussion to do the work as soon as we possibly can. The bandwidth is just not there.”

LTC Sector Should Have “Entirely And Properly Federally Funded Safety Net,” State Association President Says

In a piece for McKnight’s Long Term Care News (5/20), Health Facilities of Maryland president and CEO Joseph DeMattos Jr. writes, “My heart breaks for people impacted by the historic threat of the COVID-19 pandemic. And while it may seem like it has already been an eternity, we still have a long battle with this virus ahead of us.” DeMattos adds, “Those of us in our sector, along with everyone one else in the United States, are still discovering the challenges COVID-19 will throw at us, but we have already learned much. … We all know now that our health care capacity is a strategic national asset, that this capacity is not uniform in capability or funding, and that the states are indeed the laboratories of innovation.” DeMattos also says that “going forward, there will be tension between the financial needs of states, the federal government’s ability to continue to write massive checks, and consumer expectations on health care access, cost and quality. … A final critical lesson is that 2020 and 2021 may be the best time in our nation’s history to seriously consider moving our sector’s part of the state/federal Medicaid partnership to an entirely and properly federally funded safety net.”

Most Business May Be Able To Avoid COVID-19 Related Lawsuits By Proving Steps Taken To Protect Employees, Residents, Legal Expert Says

McKnight’s Senior Living (5/20, Novotney) reports, “Despite efforts by Republican lawmakers to create stronger liability protections for health care workers and small businesses hammered by the pandemic, COVID-19-related lawsuits still are likely to be pursued, according to a New York M&A litigator” during “an Economic Club of New York teleconference on Monday.” The expert “noted, however, that most businesses should be able to avoid lawsuits by proving they have been taking steps to protect employees and customers (or residents, in the case of long-term care facilities).” This “includes providing ‘appropriate safety equipment’ to workers, he added.”

Legal Planning Needed Due To Prevalence, Likelihood Of Government Investigations Overlapping Private Tort Suits In Long-Term Care, Experts Say

In a piece for McKnight’s Long Term Care News (5/20, Barnard, Steinberg, et al.), a group of eight, including two law firm shareholders, writes, “Despite even the best compliance measures, the legal issues presented by simultaneous, or parallel, legal actions, plaintiffs’ lawyers, qui tam relators, and federal and state enforcement agencies are anything but ‘business as usual’ from a legal perspective” in long-term care. According to the group, investors and owners, “normally protected by corporate structure, may face exposure,” while “risks and costs normally covered by insurance may be excluded.” The group says, “While these issues in isolation are not new legal issues, the prevalence and likelihood of parallel government investigation with private tort suits in large numbers makes legal planning essential for survival. Many of these legal issues have different answers based on jurisdiction, and will require detailed legal research, on a state by state and federal basis. However, identifying and preparing for some of the unique issues will position a facility to survive the current legal crossroads.”

CMS Guidance For SNF Re-Opening Includes Guidance Issues In Addition To Testing, Such As Staffing, Community Case Status

Senior Housing News (5/19, Sudo) reports that “on Monday, the Centers for Medicare & Medicaid Services (CMS) issued guidance to ensure that nursing homes have safe re-opening plans as states prepare to relax lockdowns stemming from the coronavirus pandemic.” This “guidance mandates that all nursing home residents and staff have the capacity to receive a single baseline [COVID-19] test, have arrangements with laboratories to process the tests, that testing continue weekly in communities with a positive case until all staff and residents test negative, and that adequate staffing plans are in place in the event an associate tests positive.” Additionally, “industry groups continue to press for access to funding in order to provide increased and continuous testing and protection.”

        McKnight’s Long Term Care News (5/20, Berger) reports the CDC guidance includes “testing residents and staff to make sure COVID-19 is not present; and inspections for those facilities that have had outbreaks.” In addition, according to the CMS, “restrictions can be relaxed based on the following factors: Status of COVID-19 cases in the local community; Status of COVID-19 cases in nursing homes; Baseline test of all residents, weekly testing of all staff, practicing social distancing, and universal source control for residents and visitors (e.g., face coverings); and access to adequate personal protective equipment (PPE).” However, “while CMS Administrator Seema Verma stated during a press briefing that states have enough tests, some governors and state nursing home chapters are saying otherwise,” claiming “there simply are not enough testing supplies.”