New guidelines and testing requirements for reopening long-term care facilities were announced last week by Gov. Ralph Northam.
He also outlined how the Commonwealth will direct $246 million, primarily from federal Coronavirus Aid, Relief, and Economic Security (CARES) Act funding, to support long-term care facilities in their response to COVID-19. In addition, Northam is directing the Virginia Department of Health (VDH) to make public facility-specific data regarding COVID-19 cases and deaths associated with long-term care facilities.
“The lockdowns of long-term care facilities to protect residents and staff from the spread of COVID-19 have been hard on residents and their families,” said Northam. “These actions will help support long-term care facilities as they ease those restrictions, while keeping their residents safe and ensuring that the public gets accurate information on the spread of this virus in these facilities.”
On May 18, the Centers for Medicare and Medicaid Services (CMS) outlined reopening criteria for nursing facilities. These criteria include a recommendation that all facilities conduct a baseline testing survey, and that facilities with outbreaks test residents and staff weekly. VDH’s state-specific guidelines for nursing home reopening require licensed nursing homes, certified skilled nursing facilities (SNFs), and certified nursing facilities (NFs) to conduct baseline and ongoing testing of all facility staff and residents while those facilities are in the first phase of the reopening process. Testing recommendations for latter phases of the reopening process are under development and will be informed by what is learned in the initial part of reopening.
Virginia will spend an additional $246 million in new funding to support nursing homes and assisted living facilities in addressing staffing shortages, increasing infection control measures, and purchasing personal protective equipment (PPE), as well as complying with the new testing requirements. The majority of funding will go to nursing facilities, which receive Medicaid payments. More than $56 million is provided for periodic testing of nursing home residents and staff. During the reconvened session in April, Governor Northam and the General Assembly agreed to increase Medicaid reimbursement to nursing homes by $20 per resident per day, to help support facilities.
This additional funding includes $152 million from the Provider Relief Fund that long-term care facilities have received for COVID-related expenses. While assisted living facilities have not benefited from this fund thus far, there is a growing recognition on Capitol Hill that these facilities should receive federal funding to offset their costs. Assisted living facilities will receive $20 million in support, nearly doubling state funding for these facilities, in recognition that these facilities are also experiencing additional costs and have not had the federal support that nursing facilities have received.
Because a majority of outbreaks in the Commonwealth have occurred in long-term care facilities, VDH, in partnership with the Virginia National Guard, has supported long-term care facilities in conducting “baseline” or point prevalence surveys (testing all residents and staff in the same time period). VDH has a goal to complete these baseline surveys of all Virginia nursing homes by July 15, 2020.
Northam also said that, given the changing nature of the pandemic in Virginia, he is directing VDH to release the names of individual long-term care facilities (nursing facilities and assisted living facilities) that have experienced a COVID-19 outbreak.
VDH has previously released aggregate data about outbreaks in long-term care facilities, given their responsibility to protect patient and facility anonymity under the Code of Virginia. However, due to the widespread nature of this pandemic, it is now unlikely that releasing facility information would compromise anonymity or discourage facilities from participating in a public health investigation. Recently released data from the federal Centers for Medicare and Medicaid Services (CMS) has also been inconsistent, creating public confusion.
Facility specific data is available online at https://www.vdh.virginia.gov/coronavirus/health-professionals/virginia-long-term-care-task-force/.