Assisted living communities will receive 15 million additional COVID-19 rapid, point-of-care antigen tests in the coming weeks, President Donald Trump announced Monday in providing an update on the nation’s coronavirus testing strategy. Although grateful, provider organizations said that more support is needed.

Overall, the president said in the Rose Garden at the White House, a total of 150 million of the tests will be deployed by the federal government, with approximately 50 million of them meant to “protect the most vulnerable communities.” Nursing homes will be sent 18 million of the tests, and home health and hospice agencies will receive 10 million.

More than 900,000 tests already have been shipped to assisted living communities after the government awarded a $760 million contract to Abbott Laboratories for its BinaxNOW COVID-19 Ag Card antigen test, according to Admiral Brett P. Giroir, assistant secretary for health at the U.S. Department of Health and Human Services and lead for COVID-19 diagnostic testing efforts. In a meeting with Argentum representatives on Monday, HHS officials estimated that 960,000 tests have been distributed to 5,600 assisted living communities, Argentum said. 

“We are relentlessly focused on protecting the vulnerable while enabling healthy Americans to go back to work,” Trump said.

Argentum President and CEO James Balda said he is pleased that the president and HHS are supporting vulnerable communities with the distribution of rapid point-of-care tests.

“As we’ve said from the beginning, testing support will go a long way in abating COVID-19 in our communities and, ultimately, combating the social isolation residents have been experiencing,” Balda told McKnight’s Senior Living. “However, we are asking that HHS strongly consider offering additional funding to help these communities to offset the costs of administering these tests, which are significant.”

Balda and National Center for Assisted Living Executive Director Scott Tittle sent a letter to HHS Secretary Alex Azar on Tuesday reaffirming the need for added financial support to procure tests, acquire personal protective equipment and effectively implement and administer wide-scale testing across senior living communities. Losses for senior living communities total $15 billion due to share declines in occupancy, they estimated.

“Such devastating losses will dramatically impede the ability of these facilities to afford and administer long-term rapid testing and vaccination efforts,” Balda and Tittle wrote. “We strongly believe that the most cost-effective and efficient manner to ensure that these senior living facilities can meet the great demands of regular testing of staff and residents is to provide a stipend to each facility which will provide appropriate reimbursement of the costs of purchasing and administering the tests. We ask that sums be made available in a similar manner as testing resources that were distributed to other types of long-term care providers.”

LeadingAge President and CEO Katie Smith Sloan said the administration’s announcement on Monday is an “important acknowledgement of the overwhelming need for testing across the aging services continuum, parts of which have been largely overlooked by the federal government for the last seven months.” Although LeadingAge members will “make good use of these supplies,” she said, they aren’t “an adequate, comprehensive solution for protecting older adults.”

“The numbers sound big, but these tests will only go so far,” Sloan told McKnight’s Senior Living. “For example, a bit of simple number-crunching reveals that the ‘surge of resources’ Vice President Pence described at [Monday’s] event is enough for around two weeks of twice-a-week testing at a skilled nursing facility with 300 employees. The reality is that this is a drop in the bucket considering the volume of testing needed by aging services providers.”

According to LeadingAge’s Assisted Living Market Snapshot Report 2019, if each of the country’s 28,900 assisted living communities receives the same number of tests, that would amount to 519 tests per community. LeadingAge calculated that, with an average of 20 employees at each community, the number equates to 25 Abbott BinaxNOW tests per employee.

A spokesperson for NCAL and its sister organization, the American Health Care Association, said the organizations also appreciate the federal government’s initiative in supplying the tests to assisted living communities and nursing homes.

“Given this vulnerable population we serve and new federal testing requirements for nursing homes, it is imperative that long-term care facilities have a steady supply of reliable tests with rapid results at an affordable cost,” AHCA / NCAL said in a statement to McKnight’s Senior Living. “We look forward to working with the administration and Abbott to continue to ensure our nation’s nursing homes and assisted living communities have the supplies, training and guidance they need to monitor their residents and staff for COVID-19.”

David Schless, president of American Seniors Housing Association, said that having access to rapid results testing kits is “critical” for communities serving older adults.  

ASHA, he said, “continues to urge the administration and the states to prioritize senior living communities for access to sufficient quantities of rapid antigen tests for the next several months in order to protect residents and staff until vaccination occurs.”

Governors urged to prioritize ‘vulnerable’

In a letter to the nation’s governors on Monday, Trump noted that the federal government last week began deploying rapid point-of-care tests to the nation’s higher-risk, vulnerable populations, including those in assisted living communities, nursing homes and communities affected by natural disasters.

The government, he added, will deploy 100 million tests to states between now and the end of the year. Although each state’s governor will be responsible for distributing and administering the tests, the letter noted, “We hope you will use them in ways to further open up your states by protecting vulnerable people.” Trump added this his administration will provide “continual supplies of BinaxNOW tests for vulnerable populations through the end of the year.”

A spokesman for the National Governors Association told McKnight’s Senior Living that the organization appreciates that the administration is “taking the lead from governors to send these tests directly to states to determine the most effective distribution plans.”

“Testing, of course, is a critical component of a governor-led public health response and long-term strategy for stopping the spread of the novel coronavirus,” said James Nash, NGA communications representative.

During his remarks Monday, Trump said the federal government “strongly encourages” the governors to use the tests in settings “uniquely in need of rapid, low-tech, point-of-care tests,” including surveillance screening in congregate settings. (In its own letter on Tuesday, AHCA/NCAL urged state leaders to make long-term care residents and staff members the “highest priority.”)

Giroir said that as of Monday, 111 million COVID-19 tests have been performed across the country at an average rate of 920,000 tests per day. The country is at an “inflection point” in testing, with an average of 3 million tests available per day, he added.

Last week, Girior said that the federal government was working with assisted living communities to deliver more tests but that the communities needed to secure Clinical Laboratory Improvement Amendment waivers to receive them.

Argentum said that HHS confirmed that all assisted living communities with a CLIA certificate of waiver will receive the rapid point-of-care tests; about 5,000 assisted living communities have such a weaver now. The Centers for Medicare & Medicaid Services announced Friday that it is streamlining the certificate application process to speed delivery of those tests.

Argentum confirmed that test distribution will be similar to that used for nursing homes and will be based on the degree of positivity within counties; facilities in areas with greater than 10% positivity (“red” counties) and those in areas with 5% to 10% positivity (“yellow”), will be prioritized. The test allocation for red counties enables testing of all staff members twice a week, whereas allocation for yellow counties enables testing of all staff members once a week.

“Once the initial round of rapid point-of-care tests has been delivered, HHS’ goal is to send tests to red and yellow COVID-19 hotspot counties only on a weekly basis,” an Argentum spokeswoman said. “However, they indicated they may revisit this issue from time to time and send more tests to facilities in green counties (less than 5% positivity) through December.”