Since March, roughly 56% of Maryland’s COVID-19 deaths have occurred in long-term care facilities, such as nursing homes and assisted living homes. But these tragic deaths aren’t the only hit that these facilities have taken. Nursing homes and assisted living facilities have suffered staffing shortages, massive costs and confusing and ever-changing protocols.
In a Joint Committee on Children, Youth and Families virtual hearing Thursday morning, advocates called on Maryland lawmakers to provide stability to nursing homes, through consistent, rapid turnaround testing protocols, higher wages for staff, reimbursements and more reliable data.
“The impact of the virus on long-term care facilities is understandable from a biological standpoint as COVID mercilessly attacks those with preexisting conditions and many older Marylanders,” said Eric Colchamiro, director of government affairs for the Maryland chapter of the Alzheimer’s Association. “Yet, from an operational standpoint, families lost loved ones during this unprecedented time also because infection control procedures were not consistently followed at long-term care facilities.”
At least 64 nursing homes were fined by the state for not following infection control protocols. Ten facilities received fines ranging from $70,000-$380,000.
But, Dana Kauffman, public policy consultant for Lifespan Network, said that 54 of those facilities were fined for not following confusing reporting guidelines, and 32 of those 54 were fined for not reporting on a daily basis.
“It took time to understand how to report, and then the process changed a week later,” Kauffman said. Of 226 care facilities inspected in Maryland, “162 nursing homes were found to be in full compliance for infection control. They should be applauded considering the global pandemic and lack of information.”
Kauffman said nursing homes and assisted living facilities struggled to secure enough personal protective equipment (PPE), as they were competing with state and federal governments for it. Eventually, Lifespan Network, which is the largest of senior care providers in the Mid-Atlantic, got a loan from a local physician to buy and distribute PPE to member facilities at a bulk rate.
Still facilities struggled with other issues, including staffing. Health care workers fell sick, had to leave to care for children at home or left because they could draw unemployment, and not face as much risk of infection, while earning as much or more than by continuing to work.
Facilities took another hit when the state stopped paying for weekly COVID-19 testing on Aug. 15, leaving nursing homes no choice but to pay private labs to test their staff every week. If a staff member tested positive, everyone in the facility had to be tested at a cost $100-$125 per test.
Because of this financial burden, on Oct. 1, Gov. Lawrence J. Hogan Jr. (R) announced that Maryland will commit $6 million to help nursing homes and assisted-living facilities pay for testing their employees. He also announced that those facilities can allow indoor visitation if the facility hasn’t had a new case in 14 days and isn’t testing for a possible outbreak. His announcement came after state health officials reported that Maryland had no virus-related fatalities — the first time since the beginning of the pandemic.
Before Oct. 1, Maryland required nursing homes to go through four phases of reopening. Whenever there was an outbreak, meaning at least one case, they had close to the public and cancel all activities and outdoor visits.
“The providers saw the decline in their residents because of that social isolation. It was so difficult, not only to not have their loved ones visiting, but not being able to do activities with them as well,” Kauffman said.
Now, if a facility hasn’t seen an outbreak in 14 days, they can go back to their activities and visitations, without building up to it in phases.
Hogan said health officials are working to expand the use of rapid antigen tests, which could be used to screen visitors.
“It was ground zero for the disease,” Sen. Mary L. Washington (D-Baltimore City) said of long-term care facilities. “We made tremendous progress, we have reduced it, we don’t want to go back.”’
Kauffman said the first six months of this pandemic has been extraordinarily difficult for nursing homes and assisted living communities.
“So many of these facilities have expended an unimaginable and unbudgeted amount of money in controlling this pandemic. And at this point, there’s really no end in sight. Those expenses are going to continue. We have to prioritize,” Kauffman said. “What these operators and health care workers need right now is stability.”