Senator Proposes $20B to Help Long-Term Care Facilities Create COVID-19 Cohorts

A senator from one of the states hit hard by COVID-19 is calling for increased funding to help long-term care facilities and nursing homes better cohort patients with the virus, while also managing the costs of testing and personal protective equipment (PPE).

“We know that works, when you separate in a long-term care facility — someone with COVID-19 from a resident who does not have it,” Sen. Bob Casey said during a virtual panel discussion hosted by Axios on Thursday that covered nursing homes’ role on the front lines of COVID-19. “We also need those dollars for testing, PPE and even surge teams.”

Pennsylvania, Casey’s home state, had more than 70,000 cases of COVID-19 and more than 5,300 deaths as of May 28, based on data compiled by the Centers for Disease Control and Prevention (CDC).

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Casey, a Democrat, has proposed Senate Bill 3768, introduced in the Senate on May 19 and referred to the Committee on Health, Education, Labor, and Pensions, according to Congress’ website.

The legislation would “provide $20 billion in emergency funding to States, Territories and Indian Tribes to support nursing homes, intermediate care facilities and psychiatric hospitals with cohorting based on COVID-19 status, namely to support costs related to staffing, testing, PPE and other essential needs,” according to a summary of the bill.

Many nursing facilities and other care settings do want to cohort and separate their COVID-19 patients from others in the facility, Casey said on the Axios panel. But the realities of nursing homes’ aging physical plants, many of which are older, make that kind of grouping difficult.

“Sometimes in a facility, they may want to separate, but they physically can’t expand or retrofit the facility to do that,” he told Axios’ Mike Allen. “We need to give them the help that they need.”

Even though the federal government has recommended testing nursing home workers once a week for COVID-19, Sen. Bill Cassidy argued on the Axios panel that this testing should be done twice weekly.

“Why twice weekly? Because if you are infected, on average five to six days later you will begin to have symptoms, but you’re shedding virus the two days before you become symptomatic,” Cassidy, a Republican from Louisiana, said. “So you may be shedding virus before you’re checked next time. So if you have [twice-weekly testing], you should begin to catch most people before they begin to shed virus.”

The state of New York has mandated twice-weekly testing for nursing home workers, though the directive ran into some challenges related to both testing availability and lab capacity as of mid-May.

The cost of testing is also an issue; one analysis from the nursing home trade group the American Health Care Association (AHCA) found that testing all nursing home residents and staffers in the U.S. once would come to $440 million.

AHCA and other industry advocates have called on the government to provide substantially more funding for long-term care facilities as the COVID-19 pandemic drags on, with AHCA in particular requesting $10 billion. The Department of Health and Human Services (HHS) last week released $4.9 billion in aid directly for nursing homes, though both AHCA and non-profit senior care trade group LeadingAge indicated that more resources are likely necessary.

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