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 AHCA/NCAL Urges Governors to Act Before More COVID-19 Outbreaks Hit LTC

The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) on Tuesday asked the nation’s governors to take “urgent action” before the imminent outbreak of more COVID-19 cases in nursing facilities and assisted living communities amid a summer spike in coronavirus cases among the general public.

Mark Parkinson, AHCA president and chief executive officer, and Scott Tittle, NCAL executive director, wrote to the National Governors Association (NGA) and state governors warning states about the immediate threat to long term care residents and staff, but also of personal protective equipment (PPE) shortages and significant delays in getting testing results for long term care residents and caregivers.

Here is a link to a pdf version of the letter.
AHCA/NCAL noted that recent independent research by Harvard Medical School, Brown University’s School of Public Health, and the University of Chicago showed the level of COVID-19 cases in the surrounding community was the top factor in outbreaks in nursing facilities. 

“In fact, our own analysis found that approximately three-quarters of all nursing home cases of COVID-19 resided in counties with greater than a 3.59 per 100,000 seven-day average rate of new cases of COVID-19,” said Parkinson and Tittle.

“Given the fact that the level of COVID in the community surrounding a nursing home is a leading indicator of cases in the facility, the major spikes of COVID cases in many states comes at a very challenging time as many states plan the reopening of long term care facilities and return of visitations from loved ones.”

Key excerpts and requests for governors outlined in the letter include:

--Expediting lab processing time and a solution for on-site testing with reliable and rapid results. AHCA/NCAL said in a recently conducted survey of its members, nearly nine in 10 (87 percent) nursing centers and assisted living communities said obtaining test results back from the lab companies is taking two days or longer (63 percent said two to four days, 24 percent said five days or more).

“The amount of time it is taking to receive testing results is hurting the ability of long term care facilities to fight the virus. Regular testing of nursing home and assisted living staff is a vital step in controlling the spread of COVID-19, but is not effective without obtaining timely test results,” the letter said. 

--Provide additional support for PPE supplies, especially N-95 masks. Currently, nearly 20 percent of nursing facilities report to the Centers for Disease Control and Prevention (CDC) that they either do not have or have less than a one-week supply of PPE, and more than half of assisted living communities have less than a two-week supply of N-95 masks and gowns, AHCA/NCAL said. N-95 masks are still not available and were not included in the Federal Emergency Management Agency shipments to nursing facilities.

“Given the fact we are several months into the response of this pandemic and the lack of PPE supplies is still an issue is very concerning. We request governors and state public health agencies help secure and direct more PPE supplies to nursing homes and assisted living communities,” the letter said.

--Work in close coordination with long term care providers on reopening facilities to visitations. “Providers are eager to welcome back family and friends to our facilities, but the health and safety of our residents and staff will always be our top priority,” the letter said. 

“With major spikes in cases in several states, we are very concerned about reopening long term care facilities. In order to protect our residents and caregivers, state public health agencies must work closely with long term care providers to ensure they have the supplies, testing, and staffing to reopen safely.”

Parkinson and Tittle in the letter said reopening long term care facilities is important for residents’ well-being, and caregivers and providers recognize the importance of visitations of family and friends. “To accomplish this goal, nursing homes and assisted living communities need additional support from federal and state public health agencies in order to protect residents and caregivers,” they said. 

In addition, the letter said, “nursing homes and assisted living communities cannot stop the virus by ourselves—not without testing, PPE, staff support, and funding, and not without support from the public health sector.”

AHCA/NCAL said the association appreciates the leadership shown by governors over the course of the pandemic, “and the support from your state public health agencies in helping long term care facilities respond to the unprecedented public health crisis.” 

Still, the long term care advocates urged governors and state health departments to closely monitor the situation in the general population county by county to determine if long term care facilities need additional resources and if visitations should be halted temporarily for the safety of residents and health care workers. 

“We know our collective priority is the well-being of our long term care residents and caregivers, and by working together, we can protect them through this pandemic,” AHCA/NCAL said.

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