The cost of testing every nursing home for the novel coronavirus could approach $440 million, according to a national association that called for taxpayer support.
A report released Wednesday by the American Health Care Association and National Center for Assisted Living estimated the cost would come to just shy of $439.7 million. The cost for Alabama would come to almost $7.55 million. That does not include the additional cost of testing assisted living centers and would be sufficient only to test every nursing home resident and employee one time.
Mark Parkinson, president and CEO of the American Health Care Association, urged the Department of Health and Human Services to approve a request for $10 billion in emergency relief.
“For months now, we have been advocating for expanded and priority testing in nursing homes to protect our residents and caregivers, but this is a significant undertaking and cost for nursing homes to shoulder on their own,” he said in a statement.
Nursing homes have been particularly hard hit by COVID-19, with the virus racing through facilities with residents who are vulnerable because of their advanced age and underlying health conditions. Because of close living quarters, one positive case quickly can turn into a full-blown outbreak.
According to the Alabama Department of Public Health, 16 percent of all COVID-19 cases have been visitors, residents or employees of long-term care facilities. The New York Times estimates those facilities account for a third of all deaths nationwide.
John Matson, a spokesman for the Alabama Nursing Home Association, told FOX10 News that 131 of the state’s 231 nursing homes have had positive cases. They have touched all but eight counties.
But when President Donald Trump’s administration suggested last week that states ensure all nursing homes have regular testing, Alabama Governor Kay Ivey balked at the unfunded mandate.
Matson said that would mean tests for 55,000 people. To put that in perspective, he compared it to the total number of tests that have been run in Alabama since the beginning of the outbreak.
“You’re talking about 55,000 tests in two weeks,” he said. “It took us three months to get to 165,000 (statewide). So we’re going to do 55,000 tests in two weeks. So, this would be a massive undertaking if you tried to pull this off.”
And even if nursing homes and governments come up with the money to run all those tests, where does that leave them a week later? The national association estimates it would cost more than $1 billion a month to comply with a recent Centers for Disease Control and Prevention recommendation to test all nursing home staff – not including residents – every week.
Matson said the state’s nursing homes follow state and federal protocols on testing. He noted that the CDC initially did not place nursing homes in its highest-priority tier for testing. He said that since late April, when the CDC upped the priority for nursing homes, Alabama facilities have been testing people with symptoms as well as asymptomatic residents at nursing homes where there have been positive cases.
But testing more broadly would require substantially more funding. Matson said private insurance and government programs like Medicaid and Medicare could pay some of that cost. But he added that funding is just one piece of the puzzle.
“That’s why you need a comprehensive plan. You don’t just don’t jump off and say we’re going to test everybody,” he said. “We gotta have a plan to deal with the test results. We’ve got to have a plan to administer the testing. We got to make sure there’s lab capacity. …
“There are a lot of questions that need to be answered before you can blanket-test or test on a rolling basis, and all of those need to be considered.”
In addition to virus testing, Matson said nursing homes have struggled to keep the facilities adequately staffed with personal protective equipment. He said the Federal Emergency Management Agency recently delivered a 14-day supply of PPE and in June will deliver another 14-day supply, although that does not include the highest-rated N95 masks.
“A 14-day supply of PPE is better than a zero-day supply of PPE,” said Matson, who added that nursing homes are working hard to fill in the gaps.
Matson said he does not expect the threat to dissipate anytime soon.
“COVID-19 is very much a real threat to the elderly and people who have multiple medical conditions,” he said. “And that’s exactly who live in nursing homes in Alabama.”