Despite heightened federal requirements for coronavirus testing in nursing homes, a state official told legislators Wednesday that facilities were still in some cases struggling to access necessary testing materials.
The federal Centers for Medicare and Medicaid Services issued guidance in August requiring that nursing home staff be tested anywhere from once a month to two times per week, depending on how prevalent COVID-19 was in the county at large.
Currently, nursing homes in over half of the state’s counties have to test staff at least once a week, owing to county COVID-19 prevalence rates of over 5%.
But Scott Brunner, deputy secretary for hospitals and facilities at the Kansas Department for Aging and Disability Services, said some facilities were struggling to meet that benchmark because of lags in the supply chain that have made accessing testing materials a struggle.
"It's a little bit of a mixed bag but I agree that the resourcing element is a concern, and we've certainly heard that and want to keep figuring out the best way to meet that," Brunner told the Joint Legislative Budget Committee.
And while the federal Department of Health and Human Services pushed out machines to process tests to 281 nursing homes in the state, many have already exhausted the testing supplies.
Others didn’t receive the kits in the first place and have had to partner with local labs to run tests or use private facilities run by Qwest or LabCorp, many of which have been swamped by high demand.
Further reinforcements from HHS and easing access to testing supplies would hopefully improve that situation, Brunner said, but it was still touch and go.
"There's a few different paths but I wouldn't characterize them as being sufficient given the volume (of tests)," he said.
Currently, if a positive test is identified in the facility via an antigen test, a follow-up test with a more accurate PCR test will be conducted.
If the second test also turns up positive, a facility must then conduct more widespread testing among residents and staff.
Once a positive test surfaces, nursing homes will generally work with local health officials and the Kansas Department of Health and Environment.
Delays in getting test results would largely render the testing process moot, said Sen. Carolyn McGinn, R-Sedgwick.
"I think if we’re going to run out we’ve defeated our purpose already," McGinn said. "The whole purpose was to identify hotspots and clusters."
Currently there are 181 clusters associated with long-term care facilities, according to KDHE data, accounting for 2,579 cases.
Too soon to say on home visitation
Even as the state and federal governments have loosened restrictions on visitors in nursing homes, Brunner said it was too soon to say how many facilities had reopened in one form or another.
Earlier this summer the state began allowing facilities to work with county health officials to make a determination as to whether a facility could begin allowing visitors back in some form.
And CMS published new guidance last week that facilities can again be open to loved ones as long as "core principles of COVID-19 infection prevention" were followed, including social distancing, temperature checks and cleaning of high-touch surfaces.
Allowing for those reunions was vital, said Rep. Kyle Hoffman, R-Coldwater, who noted it is a common area of complaint for constituents.
"They're not happy that they've got loved ones who are paying ... to be in a facility, and they're not being able to go and see them and their loved ones don't understand exactly why they're not able to see them," Hoffman said.
McGinn echoed that sentiment.
"The question is is there another pandemic because people are dying because of loneliness," she said.
Given the recent changes in federal guidance, a clearer picture on the matter isn’t yet available, Brunner said.
And he noted that one COVID-19 infection can change even the best laid plans of a nursing to allow visitors back in.
But KDADS said it has been in contact with facilities about how the reopening process is going, even if visitations look different than they did before the pandemic.
"It may be limited to window visits or telephone visits or outside visits," Brunner said. "So it's a pretty mixed environment."