Associations representing assisted living operators are calling attention to the fact that in some states, assisted living communities are being left out of testing and data initiatives.
At the national level, AMDA – The Society for Post-Acute and Long-Term Care Medicine, said that although some states are issuing orders for universal COVID-19 testing at assisted living communities and nursing homes, testing needs to be part of a broader strategy to address costs, staffing, frequency and type of tests.
AMDA issued a policy statement citing a number of issues that should be addressed before implementing a universal testing strategy, including defining universal testing and frequency, identifying who should be tested and what type of test to use, paying for tests, addressing test results and access to testing, planning for staffing impacts, and preparing for the emotional impact of repeated testing of residents.
The policy statement points out that mandates for universal testing differ by state and populations. Some include only nursing homes, whereas others include assisted living facilities. Both populations, according to the statement, are vulnerable, and testing is an “important concern for multilevel campuses where spread can occur from one level of care to another.”
“Testing alone is not enough, and there are no one-size-fits-all solutions,” said AMDA Executive Director Christopher E. Laxton, adding that plans must address clinical case-finding, staff screenings, visitor restrictions and transmission prevention with universal masking, appropriate use of personal protective equipment and environmental cleaning.
Although universal testing mandates are well-intentioned, AMDA states, they miss the mark in many ways because post-acute and long-term care “expertise and situational understanding” was not included when policies were developed.
“Testing decisions must be individualized to the facility with a clear understanding of the regional prevalence of disease, local testing accessibility and capacity, and well-defined goals of testing,” according to the policy statement.
Virginia ‘dashboard’ leaves out assisted living figures
In Virginia, the Virginia Hospital and Healthcare Association published a “Licensed Nursing Homes Dashboard” from the Virginia Hospital Alerting and Status System that shows COVID-19 cases and personal protective equipment needs across the state.
The problem, according to senior living organizations, is that the dashboard does not include any data from assisted living communities, which share many of the same concerns and needs of nursing homes as they, too, battle COVID-19, even though assisted living communities are reporting data to VHASS.
The Virginia Health Care Association – Virginia Center for Assisted Living, LeadingAge Virginia and the Virginia Assisted Living Association said the dashboard, which is based on data voluntarily provided by long-term care facilities reporting to VHASS, “shows only a partial picture of the ongoing needs of Virginia’s long-term care facilities.”
“We continue to encourage providers to be transparent in communications with officials, staff members, residents and public stakeholders, but we also encourage discretion in interpreting any report data to make sure that one community’s experience or needs are not implied of another community,” VALA Executive Director Judy Hackler said in a statement. “Each community has unique needs and has varying support channels.”
Keith Hare, president and CEO of VHCA-VCAL, said in a statement that the public reporting illustrates the ongoing urgent need to support long-term care.
“This information reinforces the need for state and federal officials to continue to rally around long-term care providers to prioritize additional testing, personal protective equipment, staffing and funding to address this crisis,” Hare said.
Texas testing order does not include assisted living facilities — for now
In Texas, Gov. Greg Abbott recently announced widespread testing in all senior living communities and nursing homes across the state. But information published by the Texas Health and Human Services Commission indicates that the testing is limited to nursing facilities.
In a webinar, the HHSC indicated the directive form the governor was for nursing facilities and that “assisted living facilities were not included in that directive.” On Sunday, HHSC reported that 30% of Texas nursing homes had confirmed cases, compared with 5.6% of assisted living facilities.
The Texas Assisted Living Association, LeadingAge Texas and the Texas Healthcare Association previously issued a call to action to elected leaders to make long-term care settings, including assisted living, a priority for pre-emptive rapid testing, personal protective equipment and emergency financial aid.