“The federal government should have acquired, contracted for tests, PPE, they should have made it available to states in much greater quantities.”

The COVID-19 virus has hit elderly populations the hardest, but despite pleas from the White House, states are not testing nursing home facilities enough. Vice President Mike Pence, leader of the coronavirus task force, and Dr. Deborah Birx, the task force coordinator, called for the nation’s 1 million care home residents and employees to be tested within two weeks, the Associated Press reported. That deadline will not be met, however.

‘Impulsive Order’

Excuses for why states will fail to meet the deadline vary from state-to-state, but common reasons cited include lack of resources and time constraints. Nebraska is even questioning the logic behind the idea, Alan Suderman reported for the Associated Press.

“At this time it would be fairly useless to do that,” said Nebraska Chief Medical Officer Dr. Gary Anthone. Instead, Anthone said the state would test on an individual basis as symptoms crop up.

Dr. Jim Wright, medical director at a Virginia facility that has already lost dozens of elderly residents, said the order was “probably not as well thought out as it could have been” and called the idea “impulsive.”

Not Enough Test Kits

Testing supplies have been the largest obstacle for nursing homes, as they have been for other aspects of American society. The American Health Care Association, the largest nursing home trade organization, said half of its member entries would be unable to meet the deadline simply because they don’t have enough test kits.

When it comes to securing test supplies, care homes have to vie for them alongside all other organizations and don’t enjoy preferential treatment, said Katie Sloan, President, and CEO of LeadingAge, an association for aging not-for-profits, in a report for Texas-based KFDM 6.

“The federal government should have acquired, contracted for tests, PPE, they should have made it available to states in much greater quantities,” said Bryan Frosh, attorney general for Maryland.

Further exacerbating the problem, staff often work in multiple facilities, which creates a situation where employees can contract the disease from a number of sources, Frosh said. 

Devasting Statistics

The need for testing nursing home facilities is best understood by the fact that one-third of all COVID-19 deaths occur in them, despite only accounting for 11% of the nation’s cases, the New York Times reported. For some states, nursing homes are the epicenter of COVID-19 outbreaks, almost exclusively.

In Minnesota and West Virginia, for example, 80% of COVID-19 deaths happened in long-term care facilities. In Virginia, where Dr. Wright questioned the Trump administration’s testing deadline, 58% of coronavirus deaths have happened in care homes. In 15 states half of COVID-19 fatalities are at nursing homes.

“Nobody really understood how vicious this virus would be and nursing homes do infection control. They deal with the flu every single year and they do it well. This virus is like nothing we’ve seen before,” Sloan said.

Up to Governors

Despite the lack of testing and the rising death toll among nursing homes, President Donald Trump blamed state leadership for the crisis. 

“I think it’s very important to do (testing) and I think, frankly, some of the governors were very lax with respect to nursing homes,” Trump said.

Some governors, like Ohio Republican Gov. Mike DeWine, have questioned the need for it, echoing some complaints from doctors.

“There’s frankly a lot of people in the medical field who would argue that the testing of everybody in that nursing home might not be the best protocol,” DeWine said.

Nursing Homes Lobby for Legal Protection

The problem in nursing homes has led some states to enact liability shield laws, POLITICO reported. Twenty states have enacted legislation that prevents families from holding nursing homes liable and lobbyist groups have taken the idea to Washington. Trump and Senate Majority Leader Mitch McConnell, R–Ky., have both listed liability shields as a precondition to any future coronavirus stimulus package.

“The last thing these providers and those on the front lines should have to be concerned with is the threat of an impending lawsuit,” said Zach Shamberg, president and CEO of the Pennsylvania Health Care Association.

There is, however, opposition to the idea of protecting nursing homes.

“The ask from the industry is sweeping. This is about the owners protecting their business and their profits,” said Biran Lee, former ombudsman and executive director for Families for Better Care. “They’re supposed to have emergency plans in place. It’s supposed to include how to work through a pandemic. They were supposed to be ready for this, they’re not.”