Image of David Grabowski, Ph.D.

With COVID-19 cases rising again in nursing homes, industry advocates say it’s time for facility operators who have not made full use of rapid tests to start doing so — before deaths begin to spike as well.

New U.S. COVID cases in the general population rose by 61% the week of Oct. 18, the latest data show. In the hard-hit Midwest, 43% of those new COVID cases were in nursing homes, according to the American Health Care Association / National Center for Assisted Living.

Point-of-care rapid antigen tests are a crucial tool in keeping these numbers from getting even more out of hand, according to experts. But many operators appear not to be using the tests, which were sent this fall to long-term care facilities as part of the federal government’s attempt to help contain infection rates, McKnight’s Long-Term Care News reported Monday.

Conflicting regulations and testing supply shortages may be hampering efforts to take advantage of these devices, said long-term care policy expert David Grabowski, Ph.D., of Harvard Medical School. 

Instead, many providers continue to rely on slower lab testing, a new study by Grabowski and colleagues found. And turnaround times — for both lab and rapid tests — remain too slow for them to be fully effective, he told McKnight’s Long-Term Care News Executive Editor James Berklan. 

CMS must ‘take to the field’ to offer operators rapid test guidance

Grabowski was a key advocate for widespread testing in nursing homes early in the pandemic. He now is recommending that the Centers for Medicare & Medicaid Services take to the field and make sure providers are better educated on how to use rapid antigen test devices. Facilty operators need more guidance on how to fit the tests into their broader infection control strategy, he said.

“Unfortunately, with the coming spike in the fall here, we’ll start seeing hospitalizations go up and spread, and then deaths go up, and then it will all lead into the nursing homes,” Grabowski said. “We’ve seen it twice already, first in the Northeast and then in the Sun Belt states. Without rapid testing … without personal protective equipment, without other factors we’re talking about, we’re destined to see this again,” he added.

Image of Mark Parkinson, president and CEO, AHCA/NCAL
Mark Parkinson, president and CEO, AHCA/NCAL

More funding is needed as well, advocates say. With most of the $175 billion Provider Relief Fund provided by the CARES Act already distributed, Congress must pass another COVID relief package during the lame duck session that starts next week, urged AHCA/NCAL President and CEO Mark Parkinson on Monday. This is necessary to support long-term care operators’ infection control efforts going forward, he said.

The recent case increases are “incredibly frustrating, as we had made tremendous progress to reduce COVID rates in nursing homes after the spike this summer in Sun Belt states,” Parkinson said.

New financial aid will be crucial in helping operators conduct regular testing, acquire personal protective equipment, hire additional staff or provide incentives to current staff members, he explained.

Meanwhile, Tuesday’s election results could certainly factor into how legislators address provider relief as well as liability protections, he told listeners on Friday as a guest speaker during LTC Properties’ third-quarter earnings call.

Residents of long-term care facilities account for 8% of the nation’s COVID-19 cases, yet 40% of its deaths, according to AHCA/NCAL.