“Abandoned” Nursing Homes Continue to Face Critical Supply and Staff Shortages as COVID-19 Toll Has Mounted

With the nation’s goodwill directed at hospitals during the coronavirus disease 2019 (COVID-19) pandemic, nursing homes became caught in a critical catch-22. Their initial pleas for personal protective equipment (PPE), diagnostic tests, and staffing support went largely ignored. Months into the crisis, as some facilities still scrounged for supplies and staff, the federal government announced phased guidance for reopening nursing homes that hinges on the very resources they don’t have. The May 18 recommendations from the Centers for Medicare & Medicaid Services (CMS) aim to direct state and local officials in relaxing restrictions for the nation’s more than 15 000 nursing homes, whose 1.3 million residents are locked down without visitors, communal meals, or group activities. They call for having adequate PPE on hand and regularly testing staff and residents for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) before ending lockdowns. Yet industry experts and representatives warned that these benchmarks will be impossible to meet without federal coordination— largely nonexistent to date—that includes a massive influx of additional funding, supply chain improvements, and manpower. The new guidance is “urgently needed,” said Terry Fulmer, PhD, RN, president of The John A. Hartford Foundation, which supports evidence-based care for older adults. But without the ability to obtain reliable testing and PPE, she said in an email, “these recommendations are not realistic.” Days after the CMS released its guidance, the US Department of Health and Human Services announced $4.9 billion in aid for skilled nursing facilities. Although industry leaders welcomed the $50 000 plus $2500 per bed for each facility, they said the funding falls short of actual needs across the long-term care continuum, including assisted living. In a statement, Katie Smith Sloan, president and CEO of LeadingAge, an organization that represents nonprofit nursing homes and other aging services, called the new funds “a start” but said they “will only go so far in addressing providers’ growing financial needs as this pandemic continues.”