Slow Turnarounds Top Nursing Homes’ List of COVID-19 Testing Issues

Lengthy processing times remain the most pressing issue for nursing homes as they work to test residents and staff, according to a recent survey from a leading industry trade group.

Just 3% of nursing home and assisted living facility operators reported the ability to receive same-day test results, the American Health Care Association (AHCA) reported, with only 10% logging next-day answers.

The majority, or 63% of respondents, said they must wait two to four days to receive results from their lab partners, with the remaining 24% forced to go five days or more without confirmation.


Those numbers underscore AHCA’s finding that 56% of operators in the space identified lab processing time as a key barrier to COVID-19 testing access, compared with the 34% that cited cost, the 22% that pointed to a lack of testing kits, and the 20% that blamed a lack of state and local government support. A further 14% identified an inability to locate companies that can process tests as a significant impediment.

AHCA, which represents for-profit nursing facilities and assisted living communities, surveyed 1,385 of its members between June 25 and June 29.

In the absence of a vaccine or proven treatments for COVID-19, testing has emerged as one of the few reliable weapons long-term and post-acute care facilities have against the disease.


But point-of-care testing, or the ability to accurately process tests at the nursing home itself, remains more theoretical than a widespread reality — requiring operators to collect samples, send them off to labs that could be located multiple states away, and await the results to come back. In the meantime, providers face difficult decisions about what to do with staffers and residents whose status remains undetermined, typically treating them as positive cases until the test can confirm or rule out infection.

While many states have succeeded in executing on one-time baseline testing for residents and workers, rapidly ballooning case counts among the general public in the South and Sun Belt have brought new urgency to fast, accurate testing for nursing homes — particularly for staff members.

“Regular testing of nursing home and assisted living staff is a vital step in controlling the spread of COVID-19, but is not effective without obtaining timely test results,” AHCA president and CEO Mark Parkinson said in a statement. “For nursing homes and assisted living communities to protect residents and staff, we need on-site testing with reliable and rapid results. With a recent uptick in COVID-19 cases among the general population, we are concerned labs will get overwhelmed and receiving results for long term care residents and staff will take longer to obtain.”

Unlike nursing home residents, whose status is less likely to change, workers who live in the community have a significant risk for exposure even after receiving a negative test result — and, in turn, introducing the virus to the facilities where they work. With economies reopening and the associated spikes of positive cases, routine testing of employees has taken on even greater importance, both in new hotspots and facilities that have managed to quash the outbreaks seen during the spring.

“They are not only going to the nursing home, and not going anyplace else,” Dr. Paula Lester, a geriatrician and associate professor at the NYU Long Island School of Medicine, said of nursing home staffers in conversation with SNN last month. “They’re living their lives, and going to the supermarket and wherever else they need to go. That’s more true now, as non-essential workers are now going out and about more as well. So you can’t assume that your staff is fine.”

But speed also plays a major role in whether testing protocols have real teeth, Lester observed.

“When we have more accurate point-of-care testing, I think nursing home staff should be prioritized for that — because if you get tested on Monday, and you don’t get the results until Wednesday, you could have been sick on Tuesday and working and not knowing it,” she said. “Now again, you’re wearing equipment, but you really want to [put in] maximal effort to protect patients and staff.”