AZ lacks virus plan for long-term care

From testing to PPEs to data disclosure, Arizona’s response to the COVID-19 impact on long-term care residents has been frustratingly underwhelming.

At what point will it turn around? Two weeks ago, Gov. Doug Ducey and his administration pledged, finally, to test all residents and staff in the state’s 147 nursing homes for the novel coronavirus and to secure personal protective equipment for the facilities.

This only after the White House – no lead horse itself on the response to the pandemic – recommended that nursing home residents and staff be tested in short order.

And this only after the state had first pushed a “testing blitz” for the general public over two weekends — even though roughly 80% of deaths attributed to the coronavirus were of folks 65 and older, many of them with underlying conditions and living in long-term care facilities. In Maricopa County, those facilities account for two of three

COVID-19 deaths.

We’re now nearing the end of May and we still do not have an accounting of how many of the more than 11,000 nursing home residents and the estimated 16,000 workers have been tested and what the results are.

We do not know how many of the homes have access to the promised masks and gowns.

We do not know how many cases there are at each facility. (The state is fighting in court the release of the data — even as the federal government is expected to independently release the same information any time now.)

We do not know the strategy on future testing of the nursing home population, diagnostic and/or antibody — even as the debate on the type and frequency of testing for health-care workers in the hospital setting rages on.

We do not know when testing may be expanded to other long-term care facilities – namely assisted living centers – whose residents are similarly vulnerable to the virus, even if they require lessconstant skilled nursing services.

We do not know how many of the assisted living facilities, licensed and overseen by the state and accounting for tens of thousands of residents and staff, have secured PPEs.

We do not know what challenges, or successes, Arizona health officials are encountering in long-term care.

Those facts and data are not immaterial.

Not when we know, from testimony last week before the U.S. Senate special committee on aging, that coronavirus data of individual nursing homes is critical for health officials to discern best practices and lessons learned, and for families who are seeking placement of a loved one during the pandemic. A stark contrast to the Ducey administration’s contention that a data release would be bad for business.

Not when we know, anecdotally, that some assisted living facilities have suffered, like nursing homes, COVID-19 spread that infected residents and staffers alike and killed multiple residents.

Not when we know that operators and an association representing assisted living facilities have openly lobbied for government assistance on testing and PPEs. Not when their requests have been met with mostly silence.

Mary Temm, who sits on the board of directors of Glencroft Center for Modern Aging in Glendale, said the facility asked the state Department of Health Services for help securing 500 to 600 gowns per day after it recorded its first positive COVID-19 case. The department, she said, offered 120 without guidance as to where to get the rest.

Glencroft Center, which operates a skilled nursing facility as well as an assisted living facility and independent living facilities, has since recorded at least 100 cases and 16 deaths. Five of the deaths were at its assisted-living facility. Glencroft has had to secure testing for its 1,600 residents and staff on its own, according to Temm.

Dave Voepel of the Arizona Health Care Association, a professional and advocacy organization representing longterm care facilities, notes that assisted living facilities don’t have a history of need of PPEs prior to the pandemic. Now in a health crisis, they have no supply chain to turn to for help.

And that’s to say nothing about the sticker shock when they do, given high demand and tight supply.

Gov. Ducey’s political inclination may be to let market forces drive solutions. But in a pandemic, is that a sound approach?

Arizona needs bolder actions on protecting vulnerable older adults against COVID-19. If the state’s chief executive doesn’t lead, who will?