"There's no reporting mechanism," said Kim Schilling, vice president of health services for Friendship Haven, which operates a nursing home in rural Iowa. "We tried the phone yesterday to find out with the Ministry of Health and it was very overwhelming for them too."
Katie Smith Sloan, president of LeadingAge, an association of nonprofit providers of aging services, said the Trump administration's focus on fines and strict reporting is the wrong approach to addressing a crisis created by federal inaction during the first few months of the pandemic was tightened.
"For seven months, nursing homes have been saving and protecting lives as they cope with staff shortages, challenges with testing and personal protective equipment, and growing unexpected costs," she said.
David Grabowski, a health policy expert at Harvard Medical School, described the federal rapid testing program as "a positive step but late in the game" and said Washington should do more to address the systemic financial and human resource issues that have long been problematic are the industry's efforts to protect vulnerable residents from infectious pathogens. Because federal reimbursements do not cover all of the cost of care in much of the country, nursing home operators, who mostly care for Medicaid patients, often lack the money to hire enough professionals willing to take on a strenuous job which has become increasingly stressful and risky due to the pandemic.
“I have no problem punishing nursing homes with gross negligence, but I feel like most of the facilities out there did their best despite dealing with sick workers, lack of resources and poor guidance from the federal government. Said Mr. Grabowski. "It would be a better approach to train workers in infection control, raise wages and offer paid sick leave."
The new testing requirements are governed by a complex set of guidelines from the Centers for Disease Control and Prevention, which are tied to the rate of positivity of tests for coronavirus infections in the county where the facilities are located. When the positivity rate in the community exceeds 10 percent, nursing homes must test their residents and staff twice a week. Testing requirements drop to once a week when the community's positivity rate is between five and 10 percent, and once a month when it's below 5 percent.
As of Sept. 13, more than 3,100 counties across the country reported positivity rates greater than 5 percent, according to CMS data.