Report Sheds Light on Why COVID-19 Cases Surge in Nursing Homes

April 9, 2020
100 percent of long-term care facility administrators confirmed there is not a database that can be accessed to self-report or investigate which facilities have cared for COVID patients and residents

As COVID-19 cases continue to present themselves in nursing homes, a new survey of 880 long-term care providers from 41 states reveals that cases are underreported in these facilities and that nursing staff are often not properly vetted.  

One key finding from the new Black Book research is that 90 percent of administrators expressed that because of scarce nursing personnel, nursing homes are forced to employ agency and per-diem clinical staff, of which they have no validation system to check their exposure status, according to the report.

"Agency nurses and aides often merely attest to where they've worked previously that week but there is no employer database to verify the contagious locations these nurses and aides have been," stated Doug Brown, President of the healthcare industry polling organization Black Book.  

Another troubling finding from the report is that 98 percent of admissions directors in post-acute care facilities stated that hospitals are discharging recovered COVID-19 patients into long-term rehab and sub-acute care without current testing results that the patient is negative at the time of admission to rehabilitation.

What’s more, 100 percent of administrators confirmed there is not a database that can be accessed by long-term care providers to self-report or investigate which facilities have cared for COVID patients and residents. "There is no private or public system in place for post-acute providers to help share this information," said Brown.

Black Book has previously reported data showing that most post-acute care providers do not exchange health information electronically with referring hospitals, physicians or home health providers.

Across the country, reports continue to emerge of surges in COVID-19 infected patients in nursing homes. The Life Care Center in Kirkland, Wash. was the first epicenter of the coronavirus outbreak,  and has been tied to approximately 40 COVID-19-related deaths. A recent JAMA Network headline read, “Nursing Homes Are Ground Zero for COVID-19 Pandemic.”

Last month, the Centers for Medicare & Medicare Services (CMS) released aggressive nursing home guidance related to COVID-19, recommending to immediately restrict all visitors and volunteers, cancel all group activities, and implement active screening of residents and healthcare personnel.

Now, 96 percent of nursing and clinical staff surveyed stated they believe their facility may no longer be the best place to house susceptible elderly patients, according to this recent research.

With 1.5 million residents in the nation's long-term care facilities, there are no massive housing alternatives but to step up surveillance and regularly test employees and prohibit the facilities' entry from all others. Nursing home visitors are now forbidden and staff is screened routinely, according to 92 percent of the respondent administrators who were surveyed.

Even with current visitor restrictions, employees and supplemental staff regularly move in and out of the facilities, significantly increasing the contacts to the COVID-19 virus, the researchers noted.

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