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Some Maryland nursing homes are struggling to coordinate COVID-19 testing for staff with critical state deadline looming

The Forest Hill Health & Rehabilitation is one of two Harford County nursing homes that have confirmed over 45 cases of coronavirus among residents and staff. Cases at Forest Hill Health & Rehabilitation and Bel Air Health & Rehabilitation were first confirmed in mid-April and residents were quarantined, said Annaliese Impink, Executive Vice President and Chief Experience Officer of SavaSeniorCare Consulting LLC.
Matt Button / The Aegis / Baltimore Sun Media Group
The Forest Hill Health & Rehabilitation is one of two Harford County nursing homes that have confirmed over 45 cases of coronavirus among residents and staff. Cases at Forest Hill Health & Rehabilitation and Bel Air Health & Rehabilitation were first confirmed in mid-April and residents were quarantined, said Annaliese Impink, Executive Vice President and Chief Experience Officer of SavaSeniorCare Consulting LLC.
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When Maryland’s health department told nursing homes in late July that the state would stop paying to test their staff members for COVID-19, the facilities were told they’d have to come up with their own testing plans by Aug. 14.

The state health department said last week that the University of Maryland School of Medicine’s Pathology Associates Lab would offer a significant discount on such coronavirus testing for nursing homes. But now, with just a few days to go before the state’s deadline, that same lab is turning numerous nursing homes away.

The lab, which also conducts testing for the state’s colleges and universities, correctional facilities and state workers, is “working urgently to ramp up” its testing capacity to accommodate the nursing homes, for whom the discounted price tag is critical, a spokesperson for the medical school said.

As a result, some nursing home industry groups are asking the state’s health department to push back Friday’s deadline.

“Providers are so frustrated that they’re given this information about this opportunity, and then they’re not able to access it,” said Allison Ciborowski, president and CEO of LeadingAge Maryland, which represents 30 nursing homes and an additional 110 affordable senior housing complexes across the state.

The state had promised that the University of Maryland lab would process COVID-19 tests for nursing homes at a rate of $40 per specimen — far lower than average.

“The best deal that we’ve been able to get, and this is across the board with all the different labs that we’ve talked to, is $75,” said Kevin Heffner, the president of the LifeSpan Network, which represents nearly 300 senior care providers in Maryland and the District of Columbia.

The University of Maryland lab has informed 23 nursing homes in the state that it will enter into testing contracts with them beginning Friday, said Deborah Kotz, spokesperson for the University of Maryland School of Medicine, in an email.

But, she added, an additional 49 labs have reached out.

“We want to emphasize that we plan to accommodate all COVID-19 testing requests of nursing homes in the state and are working urgently to ramp up our onboarding capacity to meet this important public health goal,” Kotz wrote.

Meanwhile, pleas from nursing home groups to extend Friday’s deadline have not been answered.

“I want to be as direct as possible with you all, in that providers need to have a contract in place by Friday 8/14,” wrote Eric Shope, a skilled nursing facility coordinator with the Maryland Department of Health, in an email Tuesday to nursing home groups. “The Secretary’s order is in place and the expectation is that it will be followed to the letter.”

In an email, health department spokesman Charlie Gischlar highlighted the federal funding available for nursing homes to tackle the testing requirement, but said officials understand that the $40 per test price offered by the University of Maryland lab is “attractive.”

“Several facilities have already established contracts with the UMPA laboratory; however, many facilities have established contracts with other labs in Maryland and are welcome to negotiate a price with those labs directly,” Gischlar said. “For example, several facilities have chosen to maintain their business relationship with CIAN Laboratories of Frederick, which has completed much of the nursing home testing to date.”

Some nursing home facilities also are struggling because the state continues to modify its list of approved COVID-19 testing sites, even as this week’s deadline looms, said Joe DeMattos, president of the Health Facilities Association of Maryland, which represents 150 nursing homes in the state. DeMattos said he’s heard from at least 10 nursing homes that contracted with a lab that was later booted from the state’s list of approved sites.

Heffner said he’d heard from about a half-dozen.

“We knew this deadline was coming, and we’ve been preparing for it in good partnership with the Maryland Department of Health,” DeMattos said. “These challenges at the last minute with the University of Maryland contractually couldn’t come at a worse time.”

The Health Facilities Association of Maryland has not called upon the state to extend the deadline, DeMattos said, but his organization has been working “16-hour days” over the past few days to help facilities meet the state’s due date.

Maryland Sen. Delores Kelly, a Baltimore County Democrat, brought up the issue at Wednesday’s meeting of the General Assembly’s COVID-19 work group. Dr. Jinlene Chan, acting deputy secretary of public health services, said the state is working with nursing homes on testing issues and she hoped federal aid would help them pay for their tests.

When the state announced in July that nursing homes would need to foot the bill for staff testing, officials said that facilities should plan to use their CARES Act funding. But that funding will run out quickly, Ciborowski said, especially if providers have to pay far more than $40 a test, and considering that they’re also likely to use the money to purchase personal protective equipment for their staff members.

“One of our members received about $590,000 in relief funds, total. And this is a medium- to large-sized facility. So the same provider estimated that it would cost them, roughly, $120,000 per month to test their staff weekly,” she said. “That amount will not stretch very far.”

So, the discounted testing on offer from the University of Maryland lab is critical, Ciborowski said, and facilities should be given more time to access it.

In addition, some nursing homes are dealing with delays in getting back results from their staff COVID-19 tests, Ciborowski said. Some had hoped that a contract with the University of Maryland lab would alleviate them, she said.

In April, the University of Maryland lab was part of a group awarded $2.5 million in state funding to start a large-scale COVID-19 testing initiative.

In the school of medicine’s April news release about the funding, officials said the lab was going to “significantly expand testing capability over the coming weeks.”