Every skilled nursing home in Pennsylvania has met the July 24 deadline for testing all residents and employees for COVID-19, the state said Tuesday.
Completing that round of tests is a key part of the plan for allowing in-person visits to nursing homes — something that hasn’t happened in Pennsylvania since early March, and which experts say has grave medical consequences of its own. But even with all of them meeting the deadline, visitation is still weeks if not months away.
If a facility has zero infections among residents and staff, it can move into the first stage of a three-stage plan for resuming visits. It takes one or more additional two-week periods of no infections before the facility can allow visitors.
Even then, visits can only take place if the facility also feels it has sufficient supplies of things such as protective equipment to prevent spread of COVID-19. And the visits take place only by appointment and facilities can impose additional controls.
Beyond that, it takes only one infection to send a facility back to stage one, resulting in another multi-week wait before it can allow visitors again.
Pennsylvania Secretary of Health Dr. Rachel Levine said Tuesday that, with all the variables, she couldn’t provide a firm estimate of when a facility with zero infections as of July 24 would be able to accept visitors.
She advised people who have a family member in a nursing home to call the facility to find out when visits will resume.
The July 24 deadline applies only to skilled nursing facilities. Personal care and assisted living facilities have until August 31 to complete testing of residents and staff. However, they can carry out the testing sooner and, if they have zero infections, can move into stage one of the plan for resuming visitation, Levine said.
The health department on Tuesday couldn’t provide details on how many nursing homes registered zero infections, a spokesman said.
The main purpose of the so-called universal testing is to keep COVID out of long term care facilities and identify employees who are carrying it but have no symptoms, which experts say it the main way COVID gets into the facilities.
In Pennsylvania, COVID has killed more than 4,800 people in nursing, assisted living or personal care facilities — nearly 70% of the state’s death toll. However, the death toll has slowed greatly as facilities have overcome things like protective equipment shortages and developed better policies for controlling infections.
However, the ban on visitors and the resulting isolation has its own serious heath toll, experts say, with the isolation contributing to ills including depression.
Some advocates argue the consequences of the isolation have become dangerously high — group dining and activities also are on hold — and the state and facilities have had enough time to resume visits while keeping residents safe from COVID. Moreover, COVID is denying countless long term care residents and their loved one of the opportunity to enjoy the resident’s final months together, with facilities typically allowing only end-of-life visits.
Pennsylvania has about 45,000 people living in about 1,200 personal care and assisted living facilities, about 80,000 living in 693 skilled nursing facilities.
Meanwhile, Levine and other experts have stressed that the prevalence of infections inside long term care facilities is a product of the level of infections in the surrounding, and strict controls are the only way to keep them out.
“I know that it’s a really difficult balance, but we cannot introduce COVID-19 into the facility,” Levine said.
Facilities will have to periodically re-test all residents and staff. The frequency will depend on things including the prevalence of COVID infections in the county where it’s located.
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