The state Department of Health and Human Services is addressing perhaps the loudest criticism of its COVID-19 oversight with testing in every private skilled nursing facility in North Carolina.
Dr. Mandy Cohen, the state’s health secretary, said Tuesday the department is collaborating with CVS Health affiliate Omnicare on the testing initiative that’s set to begin in July and continue into August.
“This testing initiative is another example of how the state is providing our facilities with valuable tools and resources,” said Adam Sholar, president and chief executive of the N.C. Health Care Facilities Association.
North Carolina has more than 400 nursing homes with about 36,000 residents and more than 30,000 staff members.
Visitor restrictions to long-term care facilities have been in place since mid-March through an executive order of Gov. Roy Cooper.
As of noon Tuesday, at least 774, or 58%, of all COVID-19 deaths statewide had occurred in nursing home or residential care facilities.
Though the 5,681 cases in those facilities represent just 9% of the statewide total, it also signifies that 16% of nursing home and residential care facility residents statewide have been infected by COVID-19.
Cooper included in Executive Order No. 138 requiring long-term care staff to wear surgical masks, and implement daily COVID-19 screenings of all staff and residents.
The Omnicare initiative assists all nursing homes in conducting a baseline test of residents and staff.
“While testing is a key component of our COVID-response strategy, it is important to remember that the actions we take as a result of that testing are most important,” said Dr. Susan Kansagra, DHHS’ section chief of Chronic Disease and Injury. “Testing will enable our skilled nursing facilities to identify positive cases earlier and better determine additional infection prevention and control measures necessary to contain spread.”
CVS Health will bill private insurance when available for testing, while DHHS will cover any additional costs.
“For observers who’ve been following the pandemic closely, a common response might be, ‘thanks ... what took you so long?’” said Mitch Kokai, senior policy analyst with Libertarian think tank John Locke Foundation.
“Experts have known for weeks — if not months — that the most severe COVID-19 problems have plagued nursing homes.
“We’ll never know how North Carolina’s COVID-19 story might have changed if DHHS and the Cooper administration had focused earlier attention on the unique challenges linked to nursing homes and the coronavirus.”
The N.C. Healthcare Association said in a statement that it "is supportive of using collaborative partnerships to expand testing and access to care for North Carolinians during the pandemic.”
Alice Bonner, an adjunct faculty member at the Johns Hopkins School of Nursing and former CDC geriatrics official, said in a recent blog that residents of nursing homes “tend to be more frail, have more functional limitations, and have more chronic and complex conditions than other older adults.”
“Nursing home residents often require help with things like using the toilet, getting in and out of bed, and getting dressed. These essential person-to-person interactions are still going to have to happen, meaning that residents and staff may be more likely than other people to spread the virus to one another.”
The new DHHS testing guidelines were announced three days after The Charlotte Observer reported Saturday that a 104-page DHHS investigation in The Citadel in Salisbury found numerous violations of federal quarantine guidelines.
The nursing home has had the state’s most COVID-19 related cases of 114 residents and 54 staff, along with the 13th-highest death total for residents at 18.
Meanwhile, The Citadel facility at 1900 W. First St. in Winston-Salem has the most cases in Forsyth County with 40 infected residents at 40, 14 infected staff, and three resident deaths.
Among the violations cited by DHHS at the Salisbury facility were a failure to notify families of infections and deaths, as well as a systemic failure to control infection.
The report said The Citadel helped create a “widespread” health crisis that put its elderly residents in “immediate jeopardy, according to the Observer.
The report says The Citadel has since addressed the failings or has plans to do so.