news 2 days ago

Nursing homes face huge testing burden

The Post-Star, Glens Falls, N.Y. — Will Doolittle The Post-Star, Glens Falls, N.Y.

May 23-- May 23--At local nursing homes where the staff has been stretched thin over the past two months, workers are being required to pour time and resources into hundreds of tests a week to meet a new state requirement.

At Fort Hudson Health System in Fort Edward, COVID-19 testing of staff started on Wednesday, and by early Friday, more than 225 tests had been performed, said CEO Andy Cruikshank.

Nursing homes have been ordered by the state to perform two tests a week on every full-time employee, one on part-timers.

Fort Hudson will be doing 580-600 tests a week, which will require a large number of staff hours and take away from other important tasks, Cruikshank said.

"It's a huge, huge resource draw. It's not just one person standing down there with a swab," he said.

Running the tests demands a lot of record-keeping.

"It takes three to five people to process each clinic," he said.

The state has been sending test kits to nursing homes, but the kits are expensive to process and insurance companies are balking at the cost.

Fort Hudson has contracted with a lab out of Texas for the work, which will cost about $60,000 a week, Cruikshank said.

The Cuomo administration issued a notice classifying the tests as medically essential to force insurance companies to cover the cost, but they're still saying no, according to Jim Clyne, CEO of LeadingAge New York, a statewide association that represents not-for-profit long-term care providers of aging services.

"The insurance companies don't agree, so they're not going to cover it. As of right now, there's no method to pay for it, that's our concern," Clyne said.

"I had a member tell me it's either payroll or paying for tests. They didn't have the money to do both," he said.

Needed, but not like this

Both Cruikshank and Clyne agreed testing is necessary for the safe operation of nursing homes, but that it should be done in a more targeted way that puts less of a time and expense burden on the facilities.

The Centers for Disease Control has recommended a program in which staff and residents would be tested twice the first week, then once a week thereafter, and direct-care staff would be given priority.

Under the state order, every full-time nursing home employee, even administrators like Cruikshank who are having no direct interaction with residents, must be tested twice a week.

"It's the right thing to do," Clyne said, of testing. "But this plan, we're not quite sure it's possible to implement. Given the lack of capacity, I don't know why they didn't go slower."

"It's a good concept but poorly executed," Cruikshank said. "I believe employee testing is important, but I wish for some reasonableness in planning it."

Order follows criticism

The testing requirement follows widespread criticism of a March order from the Cuomo administration that nursing homes could not turn away COVID-positive patients. At that time, downstate hospitals were being overwhelmed with COVID patients, and nursing homes were seen as a safety valve.

As the crisis ebbed and hospital beds opened up, the order was rescinded. But some people have blamed Gov. Andrew Cuomo for subsequent infections and deaths, saying his order brought the disease into nursing homes.

That was not the case at Fort Hudson, Cruikshank said. Fort Hudson had only one transfer of a COVID-positive patient, and that person was kept isolated with a dedicated staff, he said.

Most likely, the disease got into the nursing home through an infected staff member who was not experiencing symptoms, he said.

However, "in some parts of the state, I am certain that policy had a detrimental impact," Cruikshank said.

As with the testing requirement, the policy was poorly thought out, he said.

"It was ready, fire, aim. And once pushback came, there was reluctance from the state to admit it was bad policy," he said.

Centers Health Care, which operates several nursing homes in the area, also considers the state testing mandate "unprecedented," but has begun doing it, according to spokesman Jeff Jacomowitz.

"It is not a secret that this is an unprecedented request from state leadership, but these are unprecedented times, and the bottom line is that the safety of our residents and staff are first and foremost our number one priority in this fight against COVID-19," he said in a statement.

Will Doolittle is projects editor at The Post-Star. He may be reached at will@poststar.com and followed on his blog, I think not, and on Twitter at

@trafficstatic.

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