The Cost Of Testing North Carolina Nursing Homes For Coronavirus

NORTH CAROLINA — Residents of nursing homes in North Carolina are among those most at risk for contracting the new coronavirus, but keeping them safe comes with a price — and that price is likely too high to pay without help from the U.S. government, a new report says.

There are 428 nursing homes in North Carolina and more than 15,400 nationwide, according to the report by the American Health Care Association and the National Center for Assisted Living. While the Centers for Disease Control and Prevention recommends testing nursing home residents and staff at least once per week, the cost of a single test for every resident and staff adds up to a staggering $440 million.

With more than 1.3 million residents and 1.6 million staff nationwide, nursing homes would require $1 billion each month to ensure adequate testing. This does not include the cost to test residents and staff at assisted living and other long-term care facilities.

That’s too high a cost to ask nursing homes to shoulder, according to Mark Parkinson, president and CEO of American Health Care Association and National Center of Assisted Living.

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In response, the groups have asked the U.S. Department of Health and Human Services to provide $10 billion in emergency relief to fund additional testing and staffing.

“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,” Parkinson said.

Here’s a look at the breakdown of nursing home testing costs in North Carolina:

• Number of nursing homes: 428
• Number of residents: 36,630
• Number of staff: 44,840
• Total number of tests required: 81,470
• Cost of one round of testing: $12.2 million

According to the CDC, older adults and especially those who have severe underlying medical conditions such as heart or lung disease or diabetes are at higher risk for developing more-serious complications from COVID-19, the disease caused by the new coronavirus.

As of Wednesday, more than 30,000 residents of nursing homes and long-term care facilities in 35 states have died due to COVID-19-related illnesses, according to the Kaiser Family Foundation. A total of 152,118 cases have been reported at those facilities.

Eight out of 10 U.S. deaths have been in adults age 65 and older, the CDC says.

In North Carolina, a total of 383 deaths have been reported among nursing home residents, accounting for about 53 percent of the state’s total fatalities, according to the North Carolina Department of Health and Human Services.

State public health officials recently announced that NC DHHS would be sending 3,000 nursing home, adult day-care, mental health and long-term care facilities throughout the state a 14-day supply of face shields, masks, gloves and shoe covers. North Carolina has also issued a temporary Medicaid rate increase for skilled nursing and rehabilitation services meant to support infection prevention.

Nursing homes are particularly susceptible to virus infections for a variety of reasons, according to AARP. Among those reasons are:

• Shortages of coronavirus tests.
• Shortages of or lack of access to personal protective equipment such as masks and gowns.
• Frequent physical contact between residents and staff.
• Understaffing.
• Employees who work in multiple facilities, increasing chances for exposure.
• Chronic problems with infection control that predate coronavirus.
• Residents sharing rooms.
• Transfers of residents from hospitals and other settings.

The CDC and the Centers for Medicare & Medicaid Services issued guidance to help nursing homes reduce the spread of COVID-19 in nursing homes. Facilities have been instructed to:

• Strictly limit visitation.
• Suspend communal dining and group activities for residents.
• Screen residents daily for fever and other COVID-19 symptoms.
• Screen anyone entering the building for symptoms and observe flexible sick leave policies for staff members.
• Require staff to wear masks.

In an earlier letter to Health and Human Services Secretary Alex Azar, Parkinson said the impact the coronavirus has had on nursing homes and long-term care facilities has been “devastating.”

Should the American Health Care Association receive additional federal aid, funds would be used not only for testing but also for personal protective equipment, salaries for expanded staff and hazard pay. In addition, some of the funds would make up lost revenue for nursing homes that have been unable to admit new residents because of the outbreak.

AARP is also pushing for policies and legislation at the federal and state levels to require more transparency around coronavirus cases in nursing homes and more support for virtual visits between residents and loved ones. The organization is calling on Congress to address the shortage of staff, personal protective equipment and tests in facilities.

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