Operators of the state’s 227 nursing homes and 137 assisted living facilities say the costs of carrying out state mandates for weekly COVID-19 testing of employees could cause sharp increases in costs and even bankrupt some facilities.
State health officials had been providing tests to nursing homes without cost as part of the response to the ongoing COVID-19 pandemic. That program ended last week. Now operators say a statewide policy is needed to provide less expensive testing.
In the meantime, facilities will be looking at costs of about $75 per test or roughly $3.8 million per week to cover the costs of employee testing. The costs are about $1.6 million more than the rate the state initially was offering.
Those estimates do not include the cost of tests for patients.
“This is an astronomical rate for those facilities to absorb,” said Danna L. Kauffman, a lobbyist at Schwartz, Metz and Wise who represents LifeSpan Network, an industry group of 300 senior care facilities in Maryland and the District of Columbia.
Maryland Health Secretary Robert “Bobby” Neall told members of the legislature’s Health and Government Operations Committee that rapid testing kits coming from the federal government to facilities around the country as well as the state’s new consortium to purchase related supplies can be the “lynchpin” of a plan to help nursing and assisted living facilities.
“I’m willing to work with the industry to see if we can come up with something suitable, sensible and sustainable, because we’re going to be doing this for a while,” said Neall. “We’ve got to get the costs down, and we’ve got to make it so people can operate these institutions.”
Neall said the state is not leaving the facilities to fend for themselves.
“I don’t want the committee to feel like we just turned our back on this industry,” he said.
Nursing homes and assisted living facilities around the state bore the brunt of the ongoing pandemic in the spring with skyrocketing infections and large numbers of deaths.
In May, the state stepped in, creating strike teams to go into facilities as well as mandating routine and regular testing of all staff.
When that program ended, many facilities pinned their hopes on being able to continue testing through the state and its new lab at the University of Maryland, Baltimore, at a cost of $40 per test.
Dennis Schrader, chief operating officer for the state Department of Health, acknowledged that few facilities so far are able to take advantage of the lower rates negotiated by the state. Of the 227 nursing homes, 72 sought contracts with the state for the $40 per test rate but only 27 so far have been approved.
Schrader said the lab is “going to systematically bring those 72 on and then expand from there.”
“We have every intention of continuing to press to create access for the $40 rate,” he said.
Lou Grimmel, chief executive officer of Lorien Health Systems, said the costs to his eight nursing homes and five assisted living facilities could be less than $1 million or as much as $5.6 million for 1,400 employees.
“I am in limbo,” said Grimmel. “I don’t know the future and how much cash my company has to have.”
In March, the federal government provided about $4.9 billion to nursing homes around the country — a flat $50,000, plus an extra $2,500 for each bed in the facility. The average check nationally was about $315,000 per facility.
“That money is spent,” said Kauffman, telling the committee the funds paid for protective equipment, pandemic-related upgrades to patient care facilities and other related costs.
A new round of funding — an expected average of less than $200,000 per facility — is expected as soon as this week but would likely only cover eight weeks of testing for staff based on the lowest possible rate, which few are getting currently.
The federal government is also shipping the first units of rapid antigen testing equipment that can provide results in 15 minutes but requires additional testing over a period of time because it can be less accurate than other tests that take longer to process.
Advocates said they’d like the state to adopt policies similar to Massachusetts and New Mexico, states that require nursing home testing based on the coronavirus positivity rate in the community.
Neall said it is something his agency would consider.
“We want to base this on science, and our scientists have to advise us,” said Neall.