Nursing homes could get federal fines over testing

The industry has pushed back, saying they need help, not fines.

Nursing homes are now federally required to regularly test staff or face fines, a move that prompted the backlash of some in the industry, saying they need help, not penalties.

The Trump administration announced Tuesday that testing will be required at a pace depending on the level of coronavirus spread in a community. Earlier in the summer, Centers for Medicare and Medicaid Services advised states to regularly test residents and staff, but this new move adds a fine for noncompliance of staff testing schedules.

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“While CMPS (civil monetary penalties) are not new, we are disappointed that the Centers for Medicare & Medicaid Services (CMS) chose to employ this punitive approach,” said Patrick Schwartz, spokesman for LeadingAge Ohio, which represents long-term care providers such as nursing homes. “LeadingAge Ohio believes that nursing homes need more support—not a pile-on of punishments—as they struggle to manage the COVID pandemic.”

In Ohio, nursing home resident deaths have climbed, as the coronavirus can enter a nursing home by a staff member that might not know they are sick, spread quickly among people living in close quarters, and cause severe illness or death among an older population with often multiple underlying conditions.

As of Wednesday, 4,044 Ohioans have died from the coronavirus since the beginning of the pandemic, and more than half of those deaths are residents who lived in long-term care communities such as nursing homes.

Nursing home leaders have asked for urgent support in the face of the pandemic, requesting help with personal protective equipment and other expenses and demands that have piled up. Assisted living communities have also faced similar struggles with infection control and testing.

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The state began an effort last week to give a baseline saliva test at all 765 assisted living facilities at no cost to the facilities, but Gov. Mike DeWine announced Thursday that some facilities noticed inconsistent results.

“We’ve paused this method of specimen collection temporarily as we conduct controlled validation testing to determine why there have been irregularities,” DeWine said.

The Associated Press reported the testing requirement for staff will be keyed to the level of virus activity in local areas. If the rate of tests coming back positive is below 5%, nursing homes will have to test staff once a month. If the rate is 5% - 10%, testing will be required once a week. If the rate is above 10%, staff will have to be tested twice a week.

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Pete Van Runkle, CEO of the industry group Ohio Health Care Association, said the counties with positive rates over 10% are mostly rural counties.

“If you’re in one of those counties, you’re required to tests twice a week and we can’t even get results back in two weeks in some cases,” Van Runkle said.

The federal government also announced it will provide $2.5 billion to help nursing homes with testing costs. The administration’s campaign to distribute fast-test machines to nursing homes and an initial supply of tests for the machines is supposed to be done by the end of September.

Van Runkle said there’s some ways to get exemptions to that testing requirement, such as if a facility can document they can’t get timely results and don’t yet have rapid testing machines.

He said many nursing homes are still waiting on rapid testing machines from the federal government, will need to then figure out supplies going forward for those machines, and are struggling to get timely lab results on testing under their current testing method.

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