Most nursing homes in North Carolina are going to have to step up staff testing for COVID-19 to meet new federal rules.
The federal government is requiring nursing homes to test for the coronavirus on a schedule that is determined by how much virus is circulating in their counties.
The frequency of nursing home testing will depend on what percentage of COVID-19 tests in each county show positive results under a new rule from the federal Centers for Medicare & Medicaid Services that went into effect Wednesday. The percent positive is a reflection of how the virus is circulating through a community.
The new federal rule means that nursing homes in most North Carolina counties will have to test staff more often than the state-required twice a month.
Dr. Mandy Cohen, state Department of Health and Human Services secretary, announced in early August a state requirement for twice-a-month staff testing at nursing homes through November, with the money to pay for it coming from the federal CARES Act.
Under the new federal rule, most nursing homes must test staff more often than that. In a few counties, nursing homes won’t have to test as often as the state required.
The NC Health Care Facilities Association, a trade group, is reviewing the requirements to support members as they comply with the new regulations, President and CEO Adam Sholar said in an emailed statement.
Nursing homes are committed to protecting residents and staff, he wrote, but more testing will add to their financial strain.
Research indicates that the biggest factor in determining whether there will be a nursing home outbreak is the prevalence of COVID-19 in the community, Sholar wrote.
“Nursing homes continue to face rising costs during the COVID-19 pandemic,” he said. “While some federal funds are available for testing, significantly increased testing will further strain the financial resources for many nursing facilities.”
Cohen said at a news conference Thursday the federal government has sent a few nursing homes testing devices and supplies that can help them do more testing. Additionally, Cohen said, the state can send nursing homes fast-acting tests it expects to get from the federal government.
Last week, the Trump administration announced a $760 million contract with Abbott Laboratories for 150 million COVID-19 tests that can show results in minutes. In a statement last week, the White House said the tests will be distributed across the country.
The expectation is the tests North Carolina receives will go to nursing homes, Cohen said, but the number of tests the state will get and when they’ll arrive is unknown.
“I think we have a number of ways in which we can assist nursing homes in trying to increase their testing,” she said.
In counties with positivity rates of less than 5%, nursing homes will have to test all staff once a month, under the federal rule. In counties with rates between 5% and 10%, nursing homes must test all staff once a week. In counties with rates above 10% nursing homes must test all staff twice a week.
Older people are more at risk of death from COVID-19. According to the state Department of Health and Human Services, 80% of COVID-19 deaths are among people 65 and older.
As of Thursday afternoon, North Carolina had 1,113 COVID-19 deaths in nursing homes out of 2,803 total deaths.
The state positive rate has been consistently higher than 5%.
According to information from CMS, most of the state’s counties from Aug. 13 to Aug. 19 had positive levels between 5% and 10%. Twenty-one counties had positive test levels greater than 10%, and where twice weekly testing is required. Fourteen counties, including Durham County, had positive levels below 5%, so nursing homes there must test staff only once a month.
Lauren Zingraff, executive director of Friends of Residents in Long Term Care, said in an email that the federal requirement is coming late.
There was no federal testing plan in place when the pandemic started in March, she wrote, no access to tests, and arguments in the state over who was going to pay for them. These deficiencies are “why we are still fighting covid within nursing homes six months into the virus,” Zingraff wrote.