Even though the death rates from the new coronavirus have declined overall, nursing homes in the U.S. have been hailed as one of the deadliest environments in the pandemic, according to a new analysis by ABC News of the latest public health data .
“Nursing home residents remain at risk,” said Drs. Jay Bhatt, an intern at Chicago and ABC News, calls “unique vulnerabilities of seniors to COVID-19 and a ‘broken and patchwork healthcare system.’
Since March, long-term supplies across the country have been destroyed by the coronavirus and about 40% of the virus-related deaths have died, data show. Residents of nursing homes have taken steps to stop the spread by closing doors for lovers, eliminating group activities and implementing strict protocols to isolate themselves.
Nationally, coronavirus infections have not led to deaths as often as earlier in the outbreak, according to public health data. While July had by far the most cases, the deadliest month of the outbreak was in April. According to the COVID Tracking Project, there were nearly 54,000 deaths in April while 25,295 deaths in July.
ABC News conducted an analysis of state-by-state reporting on positive cases and deaths in American nursing homes. And more than six months after trying to combat the outbreak, those numbers show the virus continues to find its way into nursing homes, killing at least 63,000 of the nation’s majority more than 162,000 coronavirus deaths.
Once the virus enters a nursing home, the percentage of positive cases that will lead to death is only small, from 21% to 18%. And in some states where the virus is slow among the general public, cases have continued to climb in nursing homes, data from state health departments show.
In New Hampshire, for example, where nursing homes accounted for 57% of deaths before the end of May, they now account for 82% of total deaths. Similarly in Kentucky, where deaths in nursing homes accounted for 56% of deaths at the end of May, they now make up 63% of those who contracted the disease. In Indiana and Ohio, where the percentage approached 50% in May, the numbers shrank to 54% of the total deaths in August.
Connecticut, Delaware, Maine, Massachusetts, Minnesota, North Dakota, Pennsylvania, and Rhode Island all show significant death rates in nursing homes, even though the overall death toll has dropped – with facilities accounting for more than 60% of each. his total number of fatalities.
Bhatt said younger patients survive better because health care facilities are getting worse on how they care for people affected by the virus. But those advances are not as easily exacerbated in nursing homes, he added, from the vulnerabilities that older adults make particularly sensitive targets – such as weakened immune systems and other health complications.
As the death toll in nursing homes remains high, several efforts are being made to protect nursing home residents. In mid-July, the federal government announced that it would send rapid test kits for COVID-19 to all reputable nursing homes in the country. So far, tests have been delivered to 1,500 locations, federal officials told ABC News.
But the new testing initiative has raised concerns among lawyers and nursing homes about the accuracy and cost of the tests.
“For me, accuracy is just as essential,” said Richard Mollot, executive director of the Long Term Care Community Coalition, an organization that advocates for nursing home residents. “If you do not have an accurate test, we are wasting people’s time and resources.”
LeadingAge, an association of nonprofit providers of aging services that includes many nursing homes, recently sent a letter to Adm. Brett Giroir, the Assistant Secretary of Health at the Department of Health and Human Services, who pointed out that although antigen testing is useful for rapid results, the tests have a 20% false-negative result. LeadingAge also estimates that weekly costs for facilities with 100 employees would be nearly $ 20,000. They did not provide any underlying figures.
According to the Department of Health and Human Services (HHS), every nursing home in the U.S. will receive one diagnostic tool and associated antigen testing. After initial distribution, nursing homes can purchase additional tests directly from the manufacturer.
“When our nursing home receives the rapid test kits, we are responsible for paying for the tests,” said Matthew Solomon, a spokesman for Aviva, a Florida nursing home. “Right now, normal COVID-19 tests cost us about $ 100 per test. And we have 300 inhabitants, how are we going to pay for that?”
Solomon said his nursing home had its first positive coronavirus case about two weeks ago and ran out of federal stimulus aid on July 31st.
The $ 2 trillion coronavirus relief passed by Congress in March created mechanisms by which nursing homes could receive federal aid to help them fight the virus and keep employees on the payroll. In late July, HHS expanded the application window for some Medicaid and Medicare-funded facilities to request additional assistance, but Solomon said its facility no longer receives federal support.
Congress has failed after weeks of debate so far to provide additional legislation for coronavirus relief after weeks of partisan fighting. Failure to pass additional legislation means funding for many programs, including those that provide support to nursing homes, will soon run out in full. In a Facebook Live event with NBC last week, Giroir acknowledged that the tests distributed to nursing homes are not as accurate as other tests, but return results faster, what he said is a key tool to help get hot spots fast identify.
“It’s much better to have a much less sensitive test that you get back within 15 minutes than a perfectly sensitive test that you get back in three days,” Giroir said.
Gail Bruno, a certified nursing assistant at a nursing home in South Florida who has seen a recent increase in coronavirus cases, says long-term facilities did not have access to tests or vital protective equipment quickly enough.
“I’m tired, it’s been months,” Bruno said. “We have 23 residents who are positive at the moment and it’s very, very scary.”
In late July, the Department of Health and Human Services announced that it would distribute $ 5 billion to nursing homes through the CARES Act Provider Relief Fund for Nursing Homes.
On Friday, the agency announced its plans to share these funds through an initial $ 2.5 billion distributed to nursing homes in mid-August to support increased testing, staffing, PPE needs and COVID-19 isolation facilities. This will be followed by additional performance-based distributions throughout the autumn that will “consider the prevalence of the virus in the local geography of the nursing home, and will be based on the ability of the nursing home in this context to COVID spread and COVID -minimize related deaths among its residents, “according to HHS.
For nursing home attorneys such as Toby Edelman, a senior policy advocate for the Center for Medicare Advocacy, the latest figures serve as the persistence of the virus in nursing home as a reminder of the challenges that facilities will face.
“Nursing homes do not have enough staff, tests, and personal protective equipment,” Edelman said, adding that as a result they “remain dangerous places, for residents and workers alike.”
ABC News staffer Dr Mark Abdelmalek and reporters Katherine Faulders, Olivia Rubin and Matthew Mosk contributed to this report.
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