Skilled nursing and assisted living communities countrywide continue to need urgent supplies of masks, gowns, and related Personal Protective Equipment (PPE) as the physical toll of caring for residents during the coronavirus (COVID-19) pandemic runs unabated, according to advocates for the long term and post-acute care profession.

Speaking to Provider, Holly Harmon, vice president for quality, regulatory, and clinical services at the American Health Care Association/National Center for Assisted Living (ACHA/NCAL), says the struggle to equip facility staff is ongoing and a major challenge.

“We cannot do this alone. We cannot beat this virus alone,” she says, noting that the association’s leadership, member facilities, and other stakeholders have worked every source to get more PPE where it is needed inside of buildings.

“We appreciate the effort of manufacturers and the public who have helped, but we still need PPE. We need more now, and more needs to be done as facilities get desperate,” Harmon says.

The reasons for the PPE shortages have not changed in the weeks since skilled nursing and assisted living communities have undertaken drastic efforts to prevent and contain the virus inside buildings. These reasons include a spike in worldwide demand, not enough supply (fed in part by the China manufacturing shutdown at the height of its COVID-19 fight), and a drawdown of federal and state emergency supplies as hospitals and other providers seek PPE to do their work as well.

“Production has not kept up with worldwide demand,” Harmon says, echoing statements made weeks ago by AHCA/NCAL leadership, who have been in constant contact with the White House COVID-19 task force, including its head Vice President Mike Pence, to make SNFs and assisted living supply needs a priority. 

“But, it’s a complex situation,” she says, pointing to the web of local, state, and federal distribution channels and agencies involved in procuring PPE. “Facilities are getting varied responses, but in general the result has been there is not enough PPE available to facilities even as the national stockpile has been released periodically to states,” Harmon says.

Other sources of PPE for long term care providers via public donations have mostly already been exhausted, as when dental offices and local colleges stepped up to help in many locales to give their masks and gowns to facilities, she says.

“Providers in many cases have been on their own in seeking various sources for PPE as far as direct purchasing, but that of course has substantial cost implications,” Harmon says. The challenge for providers is being able to make the full payment upfront that is demanded by manufacturing and other markets for these shopping forays.

“And, even then sometimes these materials being bought in this way are not necessarily the most reliable,” she says.