En español | Fewer than 10 percent of nursing homes across the country are able to get COVID-19 test results to residents within 24 hours, according to a new study that suggests testing procedures are taking too long to guard against virus outbreaks in long-term care.
The report, published Friday by the Journal of the American Medical Association, found that tests took longer, on average, in for-profit facilities and at nursing homes with larger shares of nonwhite residents. Its findings are likely to fuel calls for a more comprehensive nursing home testing strategy.
"It's unconscionable how bad [nursing home testing] has been,” says Michael Mina, M.D., an epidemiologist and assistant professor at the Harvard University T.H. Chan School of Public Health who was not affiliated with the study. “One of the best things we could possibly do is frequent testing in all nursing homes."
Long-term care facilities account for roughly 40 percent of all U.S. coronavirus deaths — representing some 87,000 victims — and winter is expected to bring much more disease and death. The study drew from federal nursing home data and showed just 9.5 percent of nursing homes reported getting COVID-19 test results to residents within 24 hours as of Sept. 27. Roughly 13.5 percent of nursing homes said they could get one-day test results for staff.
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That's an improvement from earlier in the month, when just 6.2 percent of staff tests and 4.8 percent of resident tests were turned around within 24 hours. But it's a far cry from the rapid testing that experts say is needed to stem coronavirus infections in nursing homes. More than a third of nursing homes said residents had to wait at least three days for results, according to the study.
"Although testing delays improved over time, the state of testing is far behind the less than 24-hour turnaround that epidemiological modeling suggests is essential to prevent COVID-19 outbreaks” in long-term care, the study said.
The researchers behind the study analyzed nursing home testing data submitted to the Centers for Medicare and Medicaid, covering more than 15,000 facilities across the country. They looked at how quickly tests were turned around between mid-August and late September. Early on, more than 40 percent of nursing homes said residents were waiting between three and seven days to get test results. That percentage dropped to roughly 35 percent by the end of September.
"There is a way to minimize the impact of this spread into facilities, and that is to be able to discern at the door who is positive and who is negative and have an abundance of caution,” Brian Lee, executive director of the Families for Better Care advocacy group, said in a recent interview with AARP, calling for nursing homes to adopt more rapid testing procedures.
Test results came more quickly in so-called “hot spot” counties with high levels of coronavirus spread. The federal government started sending point-of-care tests to hot spot counties in July.
But results varied by the type of nursing facility that was studied. Among facilities with the highest concentration of nonwhite residents, 43.5 percent reported having to wait two or more days for resident test results.
A recent analysis of federal nursing home data from AARP found that more than a quarter of facilities nationwide were reporting shortages of personal protective equipment (PPE) and staff, and almost half have staff infected with COVID-19.