Update from Massachusetts Senior Care Association President Tara Gregorio Regarding Efforts to Combat COVID-19 in Skilled Nursing Facilities
The elderly, both those living in skilled nursing facilities or in the community, remain particularly vulnerable to contracting the COVID-19 virus and, those with underlying health conditions are especially at risk. It is widely predicted by public health authorities that even with all current efforts that are underway, the number of COVID-19 cases among nursing home residents and their frontline caregivers will surge along with the statewide surge.
The Massachusetts Senior Care Association and our members continue to work closely with all public health agencies to prevent the spread of the illness in our facilities and take any and all precautions to protect our residents and staff. Despite all of our collective mitigation efforts and the dedication of our frontline staff, we anticipate an increasing number of nursing facility residents and their caregivers will test positive for COVID-19.
As we continue to learn more about the spread of this highly infectious virus, the CDC has recently published data confirming elderly people can be asymptomatic while simultaneously being highly contagious for up to 7 days. Another CDC report shows that 6% to 12% of COVID-19 infections in the general public are spread from people without symptoms over the preceding 1-3 days. As a result, the CDC’s March 27th Weekly Report for nursing homes shows that previous government guidance on symptom-based screening in skilled nursing facilities was essentially inadequate and failed to identify approximately half of all residents who were infected with COVID-19. We therefore urge government agencies to revise their testing criteria, thereby ensuring a greater number of nursing home residents and staff qualify for testing. This would allow for quick and appropriate treatment, as well as the swift implementation of isolation protocols in order to further reduce the risk of spread. Without testing of staff, we have more staff staying at home who may not have COVID-19. We are hopeful that recent efforts to utilize the National Guard to perform testing in nursing facilities will allow for both greater access to testing for our residents and staff with quicker results.
MSCA continues to keep nursing facilities informed with fact-based data and best practice guidance that is based on the most currently available data and information from the CDC, the Department of Public Health and other federal and state agencies. It's important to note that this is a very fluid situation and, as those agencies learn more about this deadly infectious virus, guidance protocols often are updated.
We continue to actively screen staff for symptoms at the start of each shift. If a fever or other symptoms are detected, staff are sent home to self-quarantine for 14 days. In addition, we are recommending that all frontline staff wear masks and symptomatic residents are isolated upon any signs of COVID-19 infection, regardless of whether a COVID-19 test has been ordered or is pending, and our staff are using full Personal Protection Equipment (PPE) at all times when entering the room of a symptomatic resident.
Personal Protective Equipment (PPE) in nursing facilities is urgently and immediately needed to protect both our residents and staff. Our most recent survey to members shows that most facilities lack essential supplies and could run out of PPE shortly. This includes surgical masks, N-95 masks, gowns, gloves, face shields, thermometer covers, and alcohol-based sanitizing gels. During this extremely critical time when these supplies are essential to prevent the spread of COVID-19, it is imperative that supplies are readily available for our frontline staff. We continue to work aggressively to secure the necessary Personal Protective Equipment (PPE) that is urgently needed to protect both our residents and our staff.
The CMS-required restriction on visitors to nursing facilities remains in place and nursing home staff are working to keep families and residents connected in a variety of thoughtful ways including video conference and phone calls.
A well-documented shortage of workers is now further exacerbated as we implement necessary isolation protocols that require far more staff in order to meet the daily needs of our residents. We recognize and applaud our dedicated staff who are working tirelessly to cover this shortfall but it's not enough. To help fill vacant positions, we continue to work with our partners throughout the health care continuum to hire furloughed healthcare workers, but this crisis is occurring when facilities are already financially vulnerable, which makes it even more imperative that necessary resources are made available by the state to quickly fund the costs of fighting COVID-19 in our facilities.
Our early estimate is that COVID-19 mitigation and response efforts will cost facilities at least $287 million due largely to skyrocketing overtime pay and contracted nurses that are needed to cover vacant shifts, and hiring of new staff to implement new government regulations. This preliminary estimate is based on mitigation costs that all facilities are implementing to prevent a more widespread outbreak. We have therefore requested immediate financial help from the Commonwealth.
Tara Gregorio, President, Massachusetts Senior Care Association