Florida nursing homes will receive rapid coronavirus testing machines from the federal government. The Department of Health and Human Services announced earlier this month it will send machines to every skilled nursing facility in the country.
But long-term care providers still have a lot of questions about when they will get their machines and how they will be able to manage routine testing. Advocates for nursing home residents are concerned the tests themselves aren’t accurate enough.
The Trump administration said more than 600 machines were shipped to hotspots across the country last week, and 84 of those are going to nursing homes in Florida that have been hit hard by the pandemic. About two dozen facilities in the Tampa Bay area will receive machines in that first batch.
It’s still unclear when the other hundreds of nursing homes in the state will get their machines.
Providers talked about the initiative during a media call last week hosted by the non-profit LeadingAge Florida.
“The question is how fast will that be rolled out, and the other side is, after we get those [machines], how are we going to purchase the test kits for rapid testing?” wondered Jay Solomon, CEO of Aviva, a senior living campus in Sarasota.
The federal government said it is sending an initial supply of tests along with each machine but after that it will be on nursing homes to purchase more tests from the manufacturer.
HHS is also requiring all facilities in states with a minimum 5 percent COVID-19 positivity rate to test staff and visitors weekly.
Florida had been requiring nursing homes test staff every two weeks, so that will have to change with the new announcement.
These are all good first steps, according to Brian Lee, executive director of the advocacy group Families For Better Care. But they’re not enough.
He said the state shouldn’t wait for federal aid to expand testing in nursing homes.
"Until we have a vaccine and until the testing happens on a frequent basis, then people are going to die,” Lee said. “It's a total guessing game who has the virus in these facilities.”
Lee is also concerned about the type of machines the federal government is sending. They conduct antigen tests, which the FDA says are less accurate than molecular tests because they are more likely to miss active coronavirus infections.
Lee has been calling on the state for months to put rapid molecular testing machines in every home.
He said in addition to helping curb the spread of coronavirus among residents and staff, having more accurate testing would allow for safer familiy visitation, which he said is crucial. Florida recently announced it would bar visitation in homes for another two months.
"The rapid testing machines would bring these broken relationships back together fractured by COVID, and it would put the families back into the facilities to be advocates for their loved ones," Lee said.
Providers have voiced concerns about the cost of frequent testing, but Lee said funding this should be a priority. He suggested the state use nursing home fines to pay for the machines.
The Agency for Health Care Administration looked into doing that, according to spokesman Patrick Manderfield. He shared a letter sent by the Centers for Medicare and Medicaid Services in June rejecting the state’s request to use civil penalties to pay for testing machines, saying “this funding would be duplicative of other federal funding streams provided during the public health emergency.”
Last week the Trump Administration announced it was issuing an additional $5 billion to nursing homes across the country and that facilities could be flexible in how they used the money, so it’s possible homes could use these funds to purchase the molecular testing machines Lee is calling for.
But regardless of what type of machine facilities use, the remaining concern is whether the supply chain can meet up with demand.
Jay Solomon, CEO of Aviva, told providers on the LeadingAge call last week that he had looked into purchasing rapid testing for his own facility.
“I was on the phone [at] the end of last week with the largest provider of those rapid testing equipment, and they told me that if I placed an order on Friday, they would hope that I could have the equipment here on site sometime in October,” he said.
Federal health leaders have made similar comments about production capacity for the tests not being fully up and running until the fall, which could be too late for nursing homes experiencing outbreaks now.
But they said they’re focused on shipping machines and initial supplies out as soon as possible.