State Inspectors Sent to Nursing Homes Without COVID-19 Tests

Eight registered nurses (RNs) working as inspectors for the California Department of Health told the Los Angeles Times that officials have not provided COVID-19 testing for those going to nursing homes to ensure compliance with infection control rules.

The nurses all spoke on condition of anonymity, telling the Times that in addition to a lack of testing, they have not been provided with personal protective equipment (PPE) that fits properly, according to the July 24 report.

“For them to send us in without testing or screening is unconscionable,” an inspector in Southern California told the Times. “I think nursing homes shouldn’t let us in.”

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California Department of Public Health Deputy Director Heidi Steinecker first told the Times that staff are supplied with proper PPE and testing, and that “our staff’s safety is important to us.”

Kate Folmarm, a spokeswoman for the health department, later said that while systematic testing has not been provided, the department has “encouraged inspectors to use their personal health insurance to seek testing on their own,” the Times wrote.

However, inspectors themselves told the Times that they have faced hurdles trying to secure tests through their plans; doctors in some cases indicated that the inspectors do not meet testing criteria, while other doctors said there were not enough tests.

The inspectors also told the Times that nursing home administrators are “visibly shocked” when they learn the inspectors have not been tested.

“They only let us in because we’re the state; they’re scared to say no,” an inspector from Southern California said.

State health officials said they do not know of any outbreaks that were caused by an inspector introducing the virus, and Folmar said six inspectors who tested positive since the start of the COVID-19 pandemic had not recently been in a facility, as determined by contact tracing questions.

About 500 inspectors have been sent to California’s roughly 1,200 nursing homes, and some facilities with the worst outbreaks were visited multiple times, public health officials told the Times.

In general, states are in charge of performing nursing home inspections on behalf of the federal Centers for Medicare & Medicaid Services (CMS). As part of CMS’s efforts to curb COVID-19 outbreaks in long-term care facilities, states have additionally been required to perform focused infection-control surveys of all properties by July 31, or face the potential loss of CARES Act stimulus funding.