AUSTIN (KXAN) — Advocates are calling for billions of dollars in funding and more focus on fighting the spread of COVID-19, specifically in assisted living facilities, not just nursing homes.
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) wrote a letter to the U.S. Department of Health and Human Services and FEMA, arguing that assisted living homes have received no direct resources or assistance, while nursing homes have received federal funding, PPE supplies and testing priority.
“What we need now is to rally around assisted living communities like the country is now doing for nursing homes – and in the same way the public health sector has around hospitals,” the letter reads. “With a vulnerable population much like nursing homes, assisted living communities will not be able to overcome this unprecedented health crisis and protect our residents and caregivers without adequate funding and resources.“
AHCA/NCAL made two requests in the letter.
- From HHS: $5 billion in Emergency Relief Funding from Health and Human Services to pay for staffing, testing and PPE equipment
- From FEMA: Expedited shipments of PPE equipment, plus an effort to work with state governments to identify additional supplies
The letter acknowledges the differences in the care the two types of homes offer, stating, “Although assisted living communities are not medical facilities, there is a health care component (e.g., assistance with daily activities, medication administration, coordinating with health care providers, etc.), contributing to a holistic approach to care.”
To note, nursing homes are regulated at the federal level, by the Centers for Medicare and Medicaid Services (CMS), while assisted living facilities are regulated at the state level.
In mid-May, Texas Governor Greg Abbott ordered testing for all skilled nursing facilities, state hospitals and state supported living centers, but no such order has been mandated for assisted living families.
“We believe that the assisted living facilities should be tested also. They are caring for people who have very similar health problems to people in nursing homes,” Laurie Beu said.
Her mom lives in a small assisted living facility in Round Rock. While her sister made calls at the state and federal level, Beu spent hours calling Williamson County Officials, trying to find out why her mom’s home wasn’t being tested. She said she was told to bring her mom of her home and to one of the drive-through testing sites.
“My mom is 91 years old. She’s in a wheelchair,” Beu explained.
KXAN spoke with her sister weeks ago about the issue, and both sisters agree — they’re shocked more hasn’t been done.
The letter from AHCA/NCAL goes on to say, “Sadly, many assisted living residents have suffered the same fate as older adults in nursing homes who have contracted the virus. Like nursing homes, our residents are among those most vulnerable to COVID-19, as more than half are above the age of 85, and many are living with underlying health conditions.”
Experts at the Texas Organization of Residential Care Homes (TORCH) said they are in favor of more funding, whether from the state or from the federal government.
“We consider this an all-hands-on-deck situation,” Executive Director John Darby said. “All of the risk factors that exist in a nursing home exist in assisted living. It’s a little puzzling to think that one has more needs than the other.”
Darby said the numbers may appear smaller for assisted living facilities when compared to nursing facilities, but that doesn’t mean resources aren’t needed.
Federal data released by CMS tracks cases and deaths in nursing homes, but there is no standardized reporting system for assisted living homes nationwide. Meanwhile, Texas Health and Human Services and the Department of State Health Services publishes numbers for nursing facilities and assisted living facilities across the state online. As of Monday, nearly 40% of nursing homes had at least one confirmed case of COVID-19. According to the same data, around 7% of assisted living homes statewide had at least one confirmed case.
There are around 1,220 nursing homes statewide and more than 2,000 assisted living facilities — more than half of which are classified as “small,” according to Darby.
Of the “small” assisted living facilities, they are only aware of one home with an outbreak.
He said nursing homes tend to have higher bed counts, housing more people in fewer facilities, and therefore necessitating more staff entering the building.
“That small facility with just 8 residents, at shift change, you are just going to see two people come in and out,” Darby said. “Whereas in a larger facility with more residents, a typical shift change has significantly more than just two people, so that opportunity for cross-contamination increases.”
At the same time, assisted living facilities face other unique challenges. For instance, Darby said many of them have faced hurdles in trying to obtain enough personal protective equipment (PPE).
He explained that nursing homes are given whats called a National Provider Identifier (NPI), identifying them as a health care provider, allowing them to purchase large quantities of things like masks and gloves from certain suppliers or manufacturers. Assisted living facilities are not issued NPIs.
“The number of sources that we are able to purchase from is extremely limited, and so that becomes almost an if not daily, an almost weekly hunt to track it down,” he explained.
Beu said the more discrepancies she learns about, the more frustrated she becomes, but she plans to keep asking questions.
“My mom took such good care of us and her grandchildren, and it’s our time to care for her now. It’s our time,” Beu said. “We’ll do whatever it takes.”