Mandatory Testing Order in New York Reveals Serious Gaps in Access for Nursing Homes

As deaths in the state’s nursing homes mounted, and calls for action grew louder, New York Gov. Andrew Cuomo last week issued an aggressive executive order requiring facilities to test all staffers for COVID-19 twice per week — under the threat of license revocation and penalties that start at $2,000 and jump to $10,000 per day.

There’s just one problem: As in the rest of the country, tests are hard to come by, and both operators and laboratories aren’t sure that they can possibly meet the order.

In order to comply with Cuomo’s new rule, which covers both nursing homes and assisted living facilities, the state would have to come up with 370,000 tests per week for the 185,000 people who work in those settings across the Empire State, according to the New York State Health Facilities Association.

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As of Friday, about 1.3 million New Yorkers in total had received tests since the beginning of the pandemic, according to the state health department, meaning senior care providers are expected to eclipse the state’s entire testing total in about three and half weeks.

“While we applaud Gov. Cuomo’s new testing directive to safeguard nursing home residents and staff, we will need significant assistance from state government to increase the availability of testing for skilled nursing and assisted living employees,” NYSHFA CEO Stephen Hanse said in a statement issued this week.

And at least in the early going, that assistance does not appear to have shown up. The New York Post reported on Friday — the same day that operators were required to submit a plan of compliance with the order or face the punishment — the state’s primary COVID-19 testing laboratory asked counties to stop sending kits amid a backlog.

Jennifer Rodriguez, the health director of Livingston County, N.Y., told the Post that the lab denied her request for 800 swab kits last week, citing testing delays of several weeks.

“We’re honestly really at a loss,” Rodriguez told the outlet. “It places a large burden and it’s almost an impossible task.”

Marc Molinaro, the executive of Dutchess County, was also told that his county’s health officials would need to find alternate processing sites for 950 completed tests, according to the Post.

Rodriguez found private labs to help shoulder the burden, the paper reported, but at a cost of $100 per test.

A state health department spokesperson told the paper that the state was working with multiple commercial labs for backup, and noted that the primary testing facility in Albany, N.Y. had been working 24 hours per day in order to process 6,000 tests last week.

When asked by SNN if the federal government had plans to directly support the increasing number of states that have issued mandatory nursing home testing orders, Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma on Thursday pointed to billions in CARES Act funding set aside for state testing initiatives.

Verma also emphasized that while comments around universal nursing home testing from the president and vice president this week remain suggestions, CMS is mulling future federal guidance on the subject.

“I think that a lot of what we’re hearing is that the states had some untapped capacity,” Verma said. “In some of the calls that we’ve had with governors, we’ve even heard them say: ‘It’s not a supply issue. It’s a demand issue.'”