Even as details of the COVID-19 vaccine emerge, bringing with them the hope that the pandemic’s threat will recede, we must remember that this battle is far from over (”Maryland could receive coronavirus vaccine by next week; hospital workers, nursing home residents to get shots first,” Dec. 8).
Testing remains a critical tool for keeping older Marylanders safe. Current surges in the state (which experts continue to link to increased cases in nursing homes), coupled with the December holidays, make testing in nursing homes more important than ever before. In the last week, Maryland has seen its highest daily case counts and highest daily death count since May. As I write this, those 60 and older in Maryland currently make up 23% of the total cases in the state, yet this same demographic accounts for more than 87% of the state’s total death toll. To date, we have has lost more than 4,000 older Marylanders to COVID-19.
Maryland’s 227 nursing homes with their roughly 38,000 health care workers have been on the front lines of COVID-19 and need continued support and resources to continue saving lives. In April, Maryland began mandating surveillance testing of staff and residents in nursing homes. The state paid for initial efforts. but on Aug. 15 ceased this support. This forced providers to pay out-of-pocket to comply with continued testing mandates and continue keeping residents and staff safe. For average sized nursing homes, this has meant upward of $280,000 on lab testing costs alone since Aug. 15. This does not account for staff time, additional protective gear, reporting, coordination, collection of specimens or any other costs related to completing the testing. Beyond increased testing costs, providers are spending more on protective gear and staffing, all while experiencing huge losses in revenue — sometimes as high as $2 million.
Testing is critical, and it is expensive. Gov. Larry Hogan’s Nov. 17 order, while well-intentioned, significantly adds to long-term care providers financial challenges. Nursing homes are now required to conduct twice-weekly testing of all staff — once with the more expensive $75 PCR test and once with a point of care (POC) test. This new mandate will cost an averaged-sized nursing home roughly $19,886 per week, just on the direct costs of testing. To manage the additional administrative burden related to completing the required POC testing, we estimate that facilities will need to designate or hire 1.5 to 2.5 full-time-equivalent workers.
Additionally, nursing homes must also test all residents once per week with PCR tests. Although the state has provided POC test kits for testing staff, which is helpful, there are many non-reimbursed expenses associated with this type of testing like staff time to coordinate testing, collect specimens, report results and increased protective gear costs necessary for keeping staff safe while administering tests. Some providers report spending as much as $30,000 per week on protective equipment during this current surge.
We are committed to continue to care for older Marylanders, but without additional support, the current testing requirements are financially and administratively unsustainable. Even when the vaccine is administered, testing and personal protective equipment will remain critical. Nursing homes and other settings that provide supports and services to older adults are a vital part of the state’s health care system. Without additional support, we will lose this precious resource, and older Marylanders could lose access to the support and care they need. We must do more to care for the providers that are supporting our fathers, mothers, brothers, sisters, aunts, uncles and grandparents and other loved ones.
Allison Ciborowski, Baltimore
The writer is president and CEO of LeadingAge Maryland.
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