As COVID-19 Cases Surge in Florida, HHS Nursing Home Testing Initiative Remains Murky

The state of Florida has seen staggering surges in COVID-19 cases, but it’s not clear still to providers in the state whether skilled nursing facilities will be among the first recipients of the point-of-care testing initiative announced last week by the federal government — or even exactly when the help will arrive.

The Department of Health and Human Services (HHS) last week announced an initiative to send point-of-care COVID-19 testing devices and kits to all SNFs in the U.S.

HHS will be sending enough supplies initially to cover testing for all residents and employees once a week for four weeks.

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After that, providers will have to obtain tests for either the Quidel Sofia and Sofia 2 Instruments and BD Veritor Plus Systems, depending on which they receive from HHS. The cost of each test should be under $25 each, though production capacity for the tests and associated supplies is not likely to be fully functional until October, according to HHS assistant health secretary Admiral Brett Giroir.

Priority for the devices will be given to 2,000 SNFs located in COVID-19 hotspots as ranked by the Centers for Medicare & Medicaid Services (CMS).

But beyond that, details are murky for providers, according to speakers at a press conference held by LeadingAge that focused on the COVID-19 status in the Sunshine State; LeadingAge is a trade group representing nonprofit senior housing and care providers.

“We understand that they’re being prioritized on the basis of of shipping to hotspots, which — you would certainly assume some Florida communities are in those hotspots,” Steve Bahmer, the president and CEO of LeadingAge Florida said during the Monday press conference. “But today, we don’t know where they’re going. We don’t know when they’ll arrive. We don’t know if there are any Florida nursing homes on that list.”

The Sunshine State has seen an average of 12,000 new COVID-19 cases per day, according to a report released Monday by LeadingAge Florida. More than 4,500 nursing home and assisted living residents have been infected, and out of 4,982 COVID-19 deaths in the state, 2,343 were long-term care residents and staff, LeadingAge reported.

Florida has done some work of its own when it comes to testing, including a mid-June order from state officials that requires nursing home and assisted living facility workers to be tested for COVID-19 every two weeks. But this uses state resources, and it’s not clear what will happen when the rule expires in September, Bahmer said.

“The lowest estimate we’ve received from members is that it would cost about $25,000 a month; the highest estimate is about $300,000 a month if the state testing resources were no longer available, and they continue to test all staff every two weeks,” Bahmer said.

Jay Solomon, the CEO of the non-profit continuing care retirement community (CCRC) Aviva — A Campus for Senior Life, said that testing just the campus’s 200 staff members every two weeks would cost approximately $60,000 per month. With almost 300 residents, that would be another $60,000 per month, he said.

“As long as we still see the positivity rate in Florida at 18%, 19%, and as we continue to see cases climb, we must provide testing for both our staff and our residents,” Solomon said. “That’s the only mechanism that we have right now to ensure that we’re keeping everybody safe.”

That makes it all the more essential to have testing to hand. But according to Katie Smith Sloan, the president and CEO of LeadingAge, there are still many questions about the testing initiative, including how those first 2,000 SNFs were selected.

For Solomon, there’s another concern — the supplies of test kits that are being sent out by the federal government. While HHS is covering the initial round, SNFs are expected to procure tests for any subsequent needs via a “concierge” service set up by BD and Quidel.

But experts had noted after the testing announcement that there needs to be a supply chain in place for nursing homes to ensure they have the supplies they need.

“I was on the phone [at] the end of last week with the largest provider of those rapid testing equipment, and they told me that if I placed an order on Friday, they would hope that I could have the equipment here on site sometime in October,” Solomon said Monday.