Nursing homes cite PPE, staffing shortages

June 11, 2020

Most nursing homes regulated by CMS and recently supplying pandemic data to the agency said they could obtain diagnostic testing for their residents. Still, hundreds reported lacking even a one-week supply of basic protective equipment such as masks, gowns, hand sanitizer and eye protection, according to data reported to CMS for the week of May 31.

Staffing shortages also are a challenge, with 60,158 confirmed cases of COVID-19 among nursing home workers, 683 deaths and 54,329 suspected cases, according to CMS data. Nearly 2,000 of the more than 12,300 nursing homes reporting data for May 31 said they faced shortages of nursing staff. More than 2,200 reported that they did not have enough aides.

Staffing shortages have been linked to employees’ fear of returning to the job, sickness as a result of exposure to the coronavirus, or nurses having minimal incentive to return to work because of insufficient pay.

An HRI analysis found that about 1,990 of reporting nursing homes did not have a one-week supply of N95 masks; more than 500 said they had no supply of N95 masks. More than 1,000 lacked access to a one-week supply of surgical masks or eye protection; nearly 2,300 reported they did not have a one-week supply of gowns. More than 800 nursing homes reported that they did not have a one-week supply of hand sanitizer as of May 31.

HRI impact analysis

The newly reported numbers suggest that nursing homes face continued challenges in getting ahead of any future COVID-19 waves.

While the number of coronavirus cases reported nationally is decreasing, the virus has left a lasting impact on the industry, with the New York Times and other media estimating that approximately 40% of total US deaths are linked to nursing homes and long-term care facilities.

The fact that the CMS data showed a majority of nursing homes now have access to testing indicates they may be able to better identify residents infected with SARS-CoV-2, which causes COVID-19, and isolate them, protecting others. However, personal protective equipment (PPE) remains a struggle for many facilities, as the data show. “Months into the crisis, it is pitiful that aging services providers are still scrounging for PPE,” said LeadingAge CEO Katie Smith Sloan in a statement last week.

While CMS preliminarily suggested a correlation between nursing home case counts and poor star ratings, academic researchers released an analysis of the data that suggests COVID nursing home outbreaks are not a reflection of quality of care and staffing.

In testimony to Congress, a University of Chicago researcher said that her team had found no meaningful relationship between COVID cases and deaths and Medicare star ratings. Modern Healthcare reached a similar conclusion with their analysis of the May 31 data and star ratings. “What's going to save lives is investing in resources across the spectrum," Harvard Medical School professor David Grabowski told the publication.

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Crystal Yednak

Senior Manager, Health Research Institute, PwC US

Erin McCallister

Senior Manager, Health Research Institute, PwC US

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