© David J. Phillip / Associated Press
More than half of the states, including Texas, Pennsylvania and Ohio, do not require their own Covid-19 inspectors to be tested before entering nursing homes, despite concerns that asymptomatic visitors may pose a risk to residents.
The federal government said in June that states are required to complete special infection control-targeted investigations of the nearly 15,000 federally-certified nursing homes by the end of August, if there is a risk of losing some federal funding. But the Centers for Medicare and Medicaid Services, or CMS, the agency that oversees nursing home inspections, does not require states to test workers who perform site visits.
The Wall Street Journal contacted health regulators in all 50 states to inquire about test requirements for nursing home residents, known as researchers. At least 26 states do not require regular testing, although some, including New Hampshire and New Jersey, said they offer it on a voluntary basis. Others, such as South Carolina, Washington and Idaho, are developing new test programs for inspectors.
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“With the increasing spread of the virus in Idaho, and researchers in and out of nursing homes, it’s the responsible thing to do,” said Niki Forbing-Orr, a spokeswoman for the Idaho Department of Health and Welfare . The state knows of two researchers who have previously tested positive for the virus, she said.
Nursing homes have been closed since March for most visitors to keep the new coronavirus out. This generally includes family members of residents, although some states are beginning to allow limited access, often in institutions outside once a nursing home has met certain requirements.
“All researchers need to be tested because they could potentially bring Covid,” said Patricia Stone, a professor at Columbia University School of Nursing. “They go from potentially one hot spot to another, and there’s so much community scattered.”
Since much of the country began reopening at the end of May, nursing homes reported an additional 82,209 Covid-19 cases, according to a Journal analysis of recent weeks’ data from CMS. The data also shows nearly 10,000 nursing home residents died from the virus from June 1 to August 2, the last day treated in the data.
The Federal Data Journal’s analysis included only nursing homes that reported data that consistently monitored government data quality and excluded some additional nursing homes that reported more Covid-19-linked deaths than total deaths. in every week.
Several states, including California, Tennessee and Colorado, are adding test mandates to their nursing home staff. Some state officials say tests are needed to protect the residents of older facilities.
“It was a no-brainer,” said David Morgan, a spokesman for the New Mexico Department of Health. “People in nursing homes and long-term care facilities are our most vulnerable populations.” In New Mexico, inspectors must be checked every month, and before visiting a facility.
California, which began testing on July 31, knows of seven inspectors who previously tested positive for the virus, according to the state’s public health department.
Some of the states that inspectors do not test regularly, including Texas and Georgia, have seen significant spread of the coronavirus among their populations, and recent cases in nursing homes, according to federal data. The Texas Health and Human Services Commission and the Georgia Department of Community Health both said they are following up on federal guidance.
“The surveys are a limited period in the facility, have it appropriate [personal protective equipment] to ensure their safety and the safety of residents and staff, ‘said Melanie Amato, a spokeswoman for the Ohio Department of Health. She said the inspectors “observe limited treatments with residents.”
A Pennsylvania Department of Health spokesman said the state is working to make sure inspectors who need testing, or have Covid-19 symptoms, have access to it.
Louisiana, which does not need to test nursing home inspectors, said months ago seven inspectors who were symptomatically tested positive for Covid-19. A Louisiana Department of Health spokeswoman said the inspectors do not provide immediate patient care, wear protective equipment and spend limited time in facilities.
Seema Verma, the CMS manager, said inspectors wear full personal protective equipment, following recommendations from the Centers for Disease Control and Prevention, and go through nursing home screening protocols. “They are protected, and the people around them are protected,” she said.
The agency “continues to look into this issue and work with the CDC to evaluate appropriate test protocols given the activities and potential exposure in a particular area,” a CMS spokeswoman said.
The CDC did not respond to a request for comment.
Protective equipment may not be enough to prevent the spread of the virus from inspectors who may not know they are infected, researchers said.
“Obviously, they need to be tested,” said Tamara Konetzka, a professor of health services at the University of Chicago. “Surveyors should by definition be in the facility and observe things … PPE is not idiotic.”
Representatives of nursing home industry also said inspectors should be checked. Several states have conducted testing requirements for nursing home staff, and CMS has said it plans to do so in states with significant Covid-19 cases in their communities.
“They need to be tested the same as the staff,” said David Gifford, chief medical officer of the American Health Care Association, a sector group. “They have the same risk as the staff, who wear PPE and are screened.”
Write to Anna Wilde Mathews at [email protected]
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