Long-term care residents, staff the focus of testing efforts

Since Montana’s novel coronavirus outbreak first surfaced in March, many local and state leaders have pondered how they can safeguard older adults and the residents and staff in assisted-living facilities and nursing homes — a group the Centers for Disease Control and Prevention considers to be one of society’s most vulnerable populations.

And in late April, Gov. Steve Bullock set an ambitious goal for COVID-19 testing in Montana when he announced the start of an extensive effort to test 60,000 additional individuals, prioritizing, among other vulnerable populations, nursing homes and assisted-living facilities.

“Montana’s nursing homes and assisted-living facilities have worked tirelessly to protect vulnerable seniors during this very challenging time and we welcome and appreciate Governor Bullock’s initiative to assure availability of testing for our staff and residents,” Montana Health Care Association Executive Director Rose Hughes said in a press release announcing the framework for testing.

During a press call on Thursday, Bullock said over half of the state’s nursing homes that have chosen to participate in the initiative have completed testing. He said 1,800 residents and staff members have been tested to date and so far no positive cases have been found. He also said about 80% of the state’s 200-plus assisted-living facilities have agreed to participate and so far, eight facilities have been tested. Those also came back with no positives.

As for the percentage of facilities that have not yet agreed to testing, Bullock said the reason is, in part, due to “a lack of educational efforts” at the state level as to the importance of participation in the initiative. But he said the state is having conversations with those facilities that are not yet on board with the testing.

Flathead County Public Health Officer Hillary Hanson said there are facilities in the valley that have agreed to participate in the efforts. However, the state health department — the entity facilitating the work — has not published the names of which facilities have been tested or have signed up to participate in testing and therefore, Hanson said she did not feel comfortable listing which facilities in the valley have participated so far.

However, according to a recent interview with Kalispell Regional Healthcare officials, one of the facilities that has performed tests is the Brendan House in Kalispell. Officials said the testing of all residents and staff at the 110-bed long-term care facility wrapped up recently and all of the results came back negative.

“That is a tremendously vulnerable population,” said Doug Nelson, chief medical officer with Kalispell Regional. “We have been very intentional in providing these high-risk groups with priority testing.”

In Flathead County alone, about 30% of the population is 60 years of age or older. And according to the most recent Area Plan on Aging, 2017 estimates show nearly 20% are over the age of 65 and nearly half of Flathead County households include a person 60 or older.

MORE THAN four million Americans are admitted to, or reside in nursing homes and skilled nursing facilities each year and nearly one million people reside in assisted-living facilities, according to the Centers for Disease Control and Prevention.

That statistic means testing all residents and staff is nothing short of a monumental task.

According to a recent study by the American Health Care Association and National Center for Assisted Living, more than 17,000 tests are required in order to test every resident and employee of nursing homes and assisted living facilities in Montana one time.

And that comes with a price estimate of nearly $2.6 million.

Collectively, the study shows it would cost upward of $672 million to test every U.S. nursing home and assisted-living community resident and staff, once. The purpose of the study, according to a press release, is to show that regular testing of long-term care facilities is unsustainable without thorough federal and state funding.

The study shows Montana has 71 nursing homes and 282 assisted-living facilities.

Assisted-living communities offer person-centered care to individuals who need some assistance with daily living activities but do not require round-the-clock skilled nursing care, like those residing in nursing centers. Many nursing homes are also known as skilled nursing rehabilitation centers, meaning they typically offer therapy to individuals following a hospital stay to help them return to the community.

In a press release announcing the study, Scott Tittle, executive director of the National Center for Assisted Living, said in a prepared statement that shortages of tests and personal protective equipment “continue to be a challenge nationwide and because assisted-living communities are not medical facilities, they have not been prioritized for testing or supplies. We encourage our elected leaders to prioritize our most vulnerable and those who care for them in long-term care settings as they allocate these critical resources.”

“With seniors among those most susceptible to the virus, the assisted-living profession, in particular, is facing historic challenges when it comes to our most sacred charge – the health and safety of our residents,” Tittle said. Jon Ebelt, spokesperson for the Montana Department of Public Health and Human Services, said in an email “federal funds are supporting the increased COVID-19 testing efforts across the state, including at participating nursing homes and assisted-living facilities.”

However, Ebelt did not say whether the funds partially or entirely cover the cost to test.

BUT COST aside, recent federal data from the Centers for Medicare and Medicaid Services (CMS) sheds light on just how vulnerable this population is and underscores the importance of more aggressive testing measures.

According to a press release from CMS, the entity announced on April 19 that nursing homes are required to inform residents, their families, and their representatives of COVID-19 cases in their facilities. The deadline to report cases was May 17, but facilities were allotted 14 days of deadline wiggle room.

And as of May 31, data from CMS shows about 13,600 nursing homes — approximately 88% of the 15,400 Medicare and Medicaid nursing homes in the U.S. — had reported the required data to the Centers for Disease Control and Prevention.

According to a recent update on the CMS website, “these facilities reported over 95,000 confirmed COVID-19 cases and almost 32,000 deaths. The next set of data will be updated in two weeks. Going forward after that, CMS plans to update the data weekly.”

The data, however, is incomplete considering 12% of the total nursing homes have yet to report and those facilities face fines if they do not comply.

As of Monday, the data did not include case or death counts for individual homes. That information is expected to be released soon.

Reporter Kianna Gardner can be reached at 758-4407 or kgardner@dailyinterlake.com