By Chris Caraveo
Twitter: @ChrisCaraveo31

Long-term care facility advocates continue to press governors around the nation to step up support for vulnerable adults.

The American Health Care Association and National Center for Assisted Living recently sent a letter to the National Governors Association, warning of imminent outbreaks at nursing homes and assisted living facilities given the major spikes in new cases in several states across the U.S. In addition, officials noted shortages of personal protective equipment and significant delays in getting testing results for long-term care residents and caregivers.

“Long term care providers are still facing serious shortages of personal protective equipment due to increased demand by every sector of the economy, not just health care, and strains on the world supply chain that have not yet recovered,” the AHCA/NCAL told the Daily Independent via email. “It’s not for a lack of trying to get PPE that long term care providers are reporting this shortage. Nursing homes and assisted living communities are desperately searching for legitimate vendors who often limit the size of their orders. We need public health officials to prioritize long term care for this equipment and direct quality shipments to providers immediately, to keep our health care heroes safe on the frontlines.”

Recent independent research by Harvard Medical School, Brown University’s School of Public Health and the University of Chicago shows the level of COVID-19 cases in the surrounding community was the top factor in outbreaks in nursing homes.

Also, the AHCA/NCAL’s own analysis found that about 75% of all nursing homes cases of COVID-19 resided in counties with greater than a 3.59 per 100,000 seven-day average rate of new cases of COVID-19.

Given this, the long-term care industry is very concerned these major outbreaks will lead to a dramatic increase in cases in nursing homes and assisted living communities, according to the association’s letter.

One way to prevent that, officials say, is to expedite lab processing time and find a solution for on-site testing with reliable and rapid results.

In a survey of its members, the AHCA/NCAL found 87% of nursing homes and assisted living communities said obtaining test results back from the lab companies is taking two days or longer — 63% said two to four days, and 24% said five days or more.

“We can’t speak specifically for Arizona, but nationally, a lack of sample collection supplies and people to collect the samples, among other reasons, have contributed to us not being able to test at the level we believe is necessary,” the AHCA/NCAL told the Daily Independent via email. “A quick turnaround time will allow for facilities to better identify who has the virus and mitigate the spread, especially with asymptomatic carriers.”

But with the recent uptick in COVID-19 cases among the general population, officials are concerned labs will get overwhelmed and receiving results for long-term care residents and staff will take even longer to obtain.

“The amount of time it is taking to receive testing results is hurting the ability of long term facilities to fight the virus,” Mark Parkinson, president and CEO of the AHCA/NCAL, stated in the letter. “Regular testing of nursing home and assisted living staff is a vital step in controlling the spread of COVID-19, but is not effective without obtaining timely test results.”

Officials are also calling for additional PPE supplies, especially N-95 masks. Currently, nearly 20% of nursing homes report to the Centers for Disease Control and Prevention that they either do not have or have less than a one-week supply of PPE, and more than half of assisted living communities have less than a two-week supply of N-95 masks and gowns, the letter states. N-95 masks are still not available and were not included in FEMA shipments to nursing homes.

The AHCL/NCAL says they are asking for N-95 masks over cloth face coverings because the former better protects individuals against the spread of the virus, especially when interacting with patients with confirmed or suspected cases.

“While face masks are important for the general public, N-95 masks are critical for healthcare workers,” the association stated. “The difference in the type of masks is how much they filter the air breathed in by an individual. N-95 masks filter out viruses and are especially important in situations with viruses that have an airborne component (COVID-19, influenza, etc.).”

Officials also want governors to work in closely with long-term care providers on reopening facilities to visitations. Providers are eager to welcome back family and friends to facilities, but the health and safety of residents and staff are top priorities, the letter states. That means ensuring they have the supplies, testing and staffing to reopen safely.

Dr. Cara Christ, director of the Arizona Department Health Services, says the agency will be working with federal partners to begin distributing rapid antigen kits and testing kits to skill nursing facilities.

“That will allow our long-term care providers to test their staff weekly, but to also test patients and as well as visitors if that’s what they wanted to implement,” she said Thursday afternoon. “We are going to work with those long-term care facilities to ensure they have the testing kits that they need to have that ongoing.

“We definitely want anyone who is in a long-term care facility to be able to spend time with their loved ones, and we know that it’s been a very long time.”

People 65 and older and those with underlying health conditions are most at risk of developing severe symptoms or death. Some people in long-term care facilities are in those risk categories. As of Friday, 2,377 cases in Maricopa County were tied to residents of long-term care facilities — 662 are hospitalized and 561 have died. Staff members accounted for 1,322 cases, 85 hospitalizations and four deaths.

Gov. Doug Ducey is also stressing the need for family members to be able to visit loved ones in these facilities.

“We should add that to our list of our incentives to remember that it’s safer at home and to wear a mask and to socially distance,” Mr. Ducey said Thursday afternoon. “We do have guidance available once we get into a safer area in terms of case and spread, where people can go visit their loved ones inside a nursing home. Part of it’s the guidance and the testing. I know how much people want to do that, and we want you to be able to do it in a safe way. So we need to continue this downward trajectory.”