Pence Recommends Testing of All Nursing Home Residents, Trump Goes Further: ‘I Will Mandate It If You’d Like’

Vice President Mike Pence on Monday told state governors that the federal government strongly recommends COVID-19 testing for all nursing home residents over the next two weeks, according to an Associated Press report — but the president later in the day indicated that he could take that guidance further.

Pence reportedly made the comments on a video conference with the nation’s governors. White House Coronavirus Task Force coordinator Dr. Deborah Birx also participated in the call, telling governors to prioritize the testing of all nursing home residents in the next 14 days — and adding that the administration would assist states that need to increase testing capacity, the AP reported.

The Federal Emergency Management Agency (FEMA) and the Department of Health and Human Services (HHS) will distribute 12.9 million swabs to states in the month of May, President Trump announced in a Monday press conference about the federal government’s testing capacity.

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“We already have them; the delivery will be very quick,” Trump said.

The supply infusion — along with $1 billion in funding — will help states meet their testing goals, which they have set “very high,” according to the president.

In response to a question about why the federal government isn’t mandating testing, and merely recommending it, Trump indicated that a stronger order could be on the table.

“I would certainly consider that. I will mandate it if you’d like. I think it’s important to do, and I think frankly some of the governors were very lax with respect to nursing homes,” Trump said, pointing to the early outbreak in Washington state as an example.

He also claimed that all states can implement widespread testing.

“They have the capacity to do it. They should be doing nursing home,” Trump said. “That is a real vulnerability.”

A lack of testing access has emerged as a key national deficiency in the fight against COVID-19, even as the death toll in nursing homes and other long-term care facilities exceeds 20,000. While the federal government and states have responded to the crisis with varying edicts — including mandatory symptom checks and the “cohorting” of COVID-19 patients away from the uninfected — operators have been stymied by insufficient, slow, or nonexistent testing mechanisms.

Given the asymptomatic transmission of the disease, an inability to routinely test vulnerable nursing home residents has left operators flying blind in the face of an existential threat.

Speaking in late April, Saber Healthcare Group chief medical officer Nancy Istenes said that the nursing home operator routinely received half of the test kits that leaders requested, forcing staff to make difficult decisions about who received precious tests and who didn’t.

Diversicare Healthcare Services last week announced that it has not been able to test all of its residents and staff, even though the tests they could submit revealed more than half of all positive cases were asymptomatic.

HCR ManorCare chief medical officer Mark Gloth said last week that his company can only get its hands on “about 10% of what we really need in our facilities.”

“You have families who justifiably are calling us up and saying, ‘Hey, how come you haven’t tested my loved one yet? The governor said that we have to do that.’ They’re hearing those reports,” Gloth said. “And our answer is: We don’t have the kits.”

And while Genesis HealthCare (NYSE: GEN) CEO George Hager told SNN that access to testing has accelerated since the start of the pandemic, the nation’s largest nursing home chain still can’t access everything it needs.

“You have a supply issue, and a logistical issue, and a capacity issue — all of which are improving, but by no means do we have the resources we need to test, to really identify where the virus exists and prevent the spread,” Hager said.

The American Health Care Association welcomed the Monday AP report, though CEO Mark Parkinson called on the federal government to provide additional stimulus funding specifically for long-term care operators — as well as asking states to deploy resources such as the National Guard to support testing efforts.

“While universal testing in nursing homes is a good first step, it’s essential that testing, with rapid results, be widely available in forthcoming weeks,” Parkinson said in a statement. “Testing will need to be repeated regularly in both nursing homes and assisted living communities to continue to monitor this situation and protect residents.”

Katie Smith Sloan, president and CEO of non-profit senior care trade group LeadingAge, criticized Trump for declaring that “we have prevailed” on testing, emphasizing the lack of access that many nursing homes currently face.

“There is no clarity on how this help is coming — two months after the start of the pandemic that requires testing to limit its spread,” Sloan said in a statement. “We need test results in minutes, not days to contain the virus and to ensure that we do not lose staff while waiting for results. We also need ongoing testing, not just a Band-Aid.”