Nursing homes experience shortage of COVID-19 tests

Published: Oct. 1, 2020 at 10:46 PM CDT
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COLUMBIA COUNTY, Wis. (WMTV) - A total of three staff members at Columbia Health Care Center have tested positive for COVID-19. All of those happened within the last month. So far, there are no infected residents.

But weeks before the outbreak, one facility employee was concerned about what might happen without more coronavirus testing in her workplace.

“It’s horrendous to our residents,” Janelle Zacho, Nursing Director of Columbia Health Care Center said. “So, to not be able to test and not being able to start opening up or letting their families come in.”

Zacho explained the emotional toll the pandemic has had on her residents while sitting in a patio chair outside the nursing home facility on a sunny day.

“And I think part of that key is us testing all the time,” Zacho said. “So, we know where we’re at so we can improve it for them.”

Zacho described her struggle to find covid-19 testing supplies to test all employees and residents, with or without symptoms, every two weeks, as directed by the state, during the spring and summer months.

“We obtained our first supplies in May,” Zacho continued. “We tested everybody in the facility, residents and staff, since then I’d say, in June I acquired another 40 supply testing kits which we utilized for our symptomatic staff and residents.”

Since then, Zacho said she’s had to prioritize testing only symptomatic employees and residents. She’s instructed her employees to wear full personal protective equipment to compensate.

“I requested supplies to do the every two-week testing that we’ve been directed to do from CMS and the state from their own memos; and I received e-mails back saying that we could not receive the supplies because of outbreaks and other testing priorities,” Zacho said.

E-mails obtained by NBC15 Investigates show the conversation between Zacho and multiple members of the Department of Health Services (DHS), asking for supplies and a reason for the delay.

In their response to Zacho, DHS employees said they needed to place a hold on the order so the agency could accommodate for “testing constraints” and “outbreaks.”

An Investigates reporter also reached out to DHS and asked about the back orders. They declined to speak on camera, but in a written response, the agency said due to a surge in COVID-19 cases across the state and nationwide, DHS has only been able to support outbreak testing, and is working to be proactive by contracting new labs to keep up, and providing a second round of relief to nursing homes and assisted living centers through the CARES Act.

“So, what the state found was that the supply of tests was not adequate to meet the every two-week basis,” John Sauer, Pres. And CEO of Leading Age Wisconsin said.

Leading Age Wisconsin is a trade association for non-profit long-term care providers. Sauer said in Wisconsin, there are about 60,000 staff members and about 25,000 residents in nursing homes.

“If we just focus on nursing homes, that’s a heavy lift,” Sauer said.

Throughout the pandemic, Sauer has regularly worked with state officials to understand the plans for care facilities, and any big changes taking place.

“So, they pulled back from that program and said, 'we’re really going to have to target those areas where there’s an outbreak in the county or where there’s an outbreak in a facility.”

And then in August, things changed.

“We’re actually going to be mandating testing for all nursing home workers, that way, we can identify which workers may be infected and make sure they’re taking the appropriate precautions,” Seema Verma, Administrator for the Centers for Medicare and Medicaid Services (CMS) said.

CMS is a federal agency that now requires all U.S. nursing homes to screen employees and residents based on a different set of rules. If they don’t comply, they could face tens of thousands of dollars in fines.

“The federal government is now mandating testing according to certain intervals, based on the prevalence of COVID in your county,” Sauer said.

That means nursing homes in counties with higher positive percentages of COVID-19, must test more frequently.

For example, if 10% or more of the population is COVID-19 positive, long-term care facilities are expected to test everyone twice a week. If the population is 5-10% is testing positive, that yields weekly testing; anything below 5% qualifies for testing twice a month.

To help meet this requirement, CMS has started sending tens of thousands of rapid COVID-19 testing machines out to nursing homes across the country. Those results come back within minutes.

“I think it’s more than a testing issue, it’s really important that nursing homes really double down on their infection control efforts because that is really what’s going to make the difference,” Verma said.

Zacho said she recently received her machine for the rapid tests and has been assigned a lab to handle COVID-19 samples, however, Zacho said she still only has enough supplies for symptomatic tests.

“It’s really difficult to look at their faces every day and see their loneliness,” Zacho said. “We’re managing, we’re testing those people who are showing symptoms, but we can’t make any advancement in progress for trying to protect people.”

NBC15 News Investigates has been in contact with DHS since Aug. 25 and asked several times if someone would speak on camera.

At 4 p.m. on Thursday, the DHS communications team sent another update by e-mail with details of a new plan to assist Wisconsin Nursing Homes.

To keep up with federal mandates, the state plans to connect more contracted labs with nursing homes and work to supply those nursing homes with more testing materials. The goal is to reach these long-term care facilities by mid-October.

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