Cost Of Testing Illinois Nursing Homes For Coronavirus

ILLINOIS — Residents of nursing homes in Illinois are among those most at risk for contracting the new coronavirus, but keeping them safe comes with a price — and that price is likely too high to pay without help from the U.S. government, a new report says.

There are 722 nursing homes in Illinois and more than 15,400 nationwide, according to the report by the American Health Care Association and the National Center for Assisted Living. While the Centers for Disease Control and Prevention recommends testing nursing home residents and staff at least once per week, the cost of a single test for every resident and staff adds up to a staggering $440 million.

With more than 1.3 million residents and 1.6 million staff nationwide, nursing homes would require $1 billion each month to ensure adequate testing. This does not include the cost to test residents and staff at assisted living and other long-term care facilities.

That’s too high a cost to ask nursing homes to shoulder, according to Mark Parkinson, president and CEO of American Health Care Association and National Center of Assisted Living.

In response, the groups have asked the U.S. Department of Health and Human Services to provide $10 billion in emergency relief to fund additional testing and staffing.

“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,” Parkinson said.

Here’s a look at the breakdown of nursing home testing costs in Illinois

• Number of nursing homes: 722
• Number of residents: 66,081
• Number of staff: 76,860
• Total number of tests required: 142,941
• Cost of one round of testing: $21,441,150

According to the CDC, older adults and especially those who have severe underlying medical conditions such as heart or lung disease or diabetes are at higher risk for developing more-serious complications from COVID-19, the disease caused by the new coronavirus.

As of Wednesday, more than 30,000 residents of nursing homes and long-term care facilities in 35 states have died due to COVID-19-related illnesses, according to the Kaiser Family Foundation. A total of 152,118 cases have been reported at those facilities.

Eight out of 10 U.S. deaths have been in adults age 65 and older, the CDC says.

In Illinois, as of May 21, a total of deaths 1,975 deaths have been reported among nursing home residents, accounting for 49 percent of the state’s total fatalities. More than 13,000 cases of coronavirus have been reported in long-term care facilities in Illinois, making up about 15 percent of Illinois' total cases.

The Illinois Department of Public Health has offered extensive guidance to long-term care facilities to help reduce the spread of coronavirus, including:

• All residents should be screened for symptoms AND temperature, heart rate, respirations (Vital signs) AND pulse oximetry every 8 hours. Blood pressure may be taken once a day.
• Any resident identified with symptoms of fever and lower respiratory illness (cough, shortness of breath, sore throat) should be immediately placed in both Contact and Droplet transmission-based precautions.
• The isolation should be implemented by the healthcare member who discovers the symptoms pending a physician order.
• Residents with confirmed COVID-19 or displaying respiratory symptoms should receive all services in room with door closed (meals, physical and occupational therapy, activities, and personal hygiene, etc.)
• Symptomatic residents should only leave their room as required for medical procedures not available on site (i.e., dialysis, medical specialist appointment, and critical testing not available at the facility).
  • If the resident is to leave room for these purposes the shortest route should be utilized and the immediate are/route to the exit/treatment areas should be cleared of all residents and unnecessary staff.
• Ensure all residents wear a cloth face covering for source control whenever they leave their room or are around others, including whenever they leave the facility for essential medical appointments. Whenever a resident is outside their room, they should wear a cloth face covering or face mask, perform hand hygiene, limit their movement in the facility, and perform social distancing (stay at least 6 feet away from others).
• Residents should wear a face covering or face mask (if tolerated) during direct care activities

Nursing homes are particularly susceptible to virus infections for a variety of reasons, according to AARP. Among those reasons are:

• Shortages of coronavirus tests.
• Shortages of or lack of access to personal protective equipment such as masks and gowns.
• Frequent physical contact between residents and staff.
• Understaffing.
• Employees who work in multiple facilities, increasing chances for exposure.
• Chronic problems with infection control that predate coronavirus.
• Residents sharing rooms.
• Transfers of residents from hospitals and other settings.

The CDC and the Centers for Medicare & Medicaid Services issued guidance to help nursing homes reduce the spread of COVID-19 in nursing homes. Facilities have been instructed to:

• Strictly limit visitation.
• Suspend communal dining and group activities for residents.
• Screen residents daily for fever and other COVID-19 symptoms.
• Screen anyone entering the building for symptoms and observe flexible sick leave policies for staff members.
• Require staff to wear masks.

In an earlier letter to Health and Human Services Secretary Alex Azar, Parkinson said the impact the coronavirus has had on nursing homes and long-term care facilities has been “devastating.”

Should the American Health Care Association receive additional federal aid, funds would be used not only for testing but also for personal protective equipment, salaries for expanded staff and hazard pay. In addition, some of the funds would make up lost revenue for nursing homes that have been unable to admit new residents because of the outbreak.

AARP is also pushing for policies and legislation at the federal and state levels to require more transparency around coronavirus cases in nursing homes and more support for virtual visits between residents and loved ones. The organization is calling on Congress to address the shortage of staff, personal protective equipment and tests in facilities.