Parkinson: ‘Worst Fears Have Come True’ as Nursing Home COVID Cases Hit New Record, Operators ‘Powerless’ to Stop Trend Alone

The number of positive COVID-19 cases in nursing homes reached a new weekly record at the start of this month as the novel coronavirus continues to expand unchecked in various parts of the country, according to a new analysis from a leading industry trade group.

Nursing homes logged 10,279 confirmed cases among residents during the week of November 1, the American Health Care Association (AHCA) announced in a new snapshot released Tuesday; that’s the largest single-week figure since the Centers for Medicare & Medicaid Services (CMS) began tracking nursing home cases and deaths back in May.

“Our worst fears have come true as COVID runs rampant among the general population, and long-term care facilities are powerless to fully prevent it from entering due to its asymptomatic and pre-symptomatic spread,” AHCA CEO Mark Parkinson said in a statement.

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AHCA represents about 14,000 nursing and assisted living facilities, primarily operated by for-profit companies.

The grim milestone came as the overall COVID-19 case count ballooned 140% to more than 500,000 during the same week.

Midwestern states led the way in nursing home COVID-19 cases, representing 47% of all confirmed positives during the week of November 1.

Weekly nursing home COVID deaths have also risen slowly over the last month, totaling 1,431 in the first week of November. That metric had fallen to around 1,000 per week for most of September, a significant dip from the nearly 3,000 reported during the week of May 31.

The connection between community spread of COVID-19 and the risk of outbreaks in nursing facilities has been fairly well established through research by this point in the pandemic; other factors, including proper staffing levels, also play a key role in whether or not facilities can curb outbreaks once the virus enters a given property.

“While potentially meaningful, these effects are dwarfed by the effect of where the virus is circulating,” University of Chicago researchers Rebecca Gorges and Tamara Konetzka wrote of staffing differences in an August study. “The largest magnitude effects we find are for county metropolitan status and county-level number of COVID-19 cases per capita that occur among the general population.”

The overall trend for COVID-19 infections shows no signs of slowing, according to a November 12 analysis from the Centers for Disease Control & Prevention (CDC).

“This week’s national ensemble forecast indicates an uncertain trend in new COVID-19 cases reported over the next four weeks and predicts that 630,000 to 1,700,000 new cases will likely be reported during the week ending December 5, 2020,” the CDC observed.

Parkinson called on Congress to pass a new COVID-19 relief package during the current lame duck session, but also stressed the importance of simple public health steps such as the continued wearing of masks and practicing social distancing.

“As long as people are irresponsibly acting in the general public, we just can’t stop it,” Parkinson said.

That’s a particular area of worry for nursing home residents and staff given the impending holiday season.

“We are especially concerned that this situation will only get worse with Thanksgiving just around the corner,” Parkinson said. “The public must realize that their actions not only endanger our nation’s most vulnerable, but also trigger government lockdowns of facilities, keeping these residents from their loved ones. This is detrimental to their health, wellbeing and happiness. We urge everyone to do their part to slow the spread immediately and exercise caution when celebrating Thanksgiving.”

The Centers for Medicare & Medicaid Services (CMS) on Tuesday acknowledged the rising case counts in a “call to action” urging operators to have their staff complete a free training program initially rolled out this past summer; the agency recognized the 1,092 facilities across the country where half or more of the employees went through the process, for a total of about 12.5% of all nursing home employees nationwide.

“Ultimately, the ownership and management of every nursing [home] must take it on themselves to ensure their staff is fully equipped to keep residents safe,” CMS administrator Seema Verma said in a statement. “With coronavirus cases increasing across the country and infection control identified as a major issue, we encourage all nursing homes to take advantage of this no-cost opportunity to train their staff.”

CMS had refocused its nursing home inspection priorities on infection control in the early days of the pandemic. The agency in August touted its issuance of $15 million in fines to nursing facilities during the course of the COVID-19 crisis, with $10 million of the total associated with infection control deficiencies.

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