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Iowa Public Health Won't Help Nursing Homes Meet Federal Coronavirus Testing Requirements

Nurse practitioner Dana Jones discovered a data error that has potentially reported thousands of recent coronavirus cases as happening months earlier. Jones said she is concerned that positivity rates may look lower than they are. Siouxland District Health is concerned about a peoples' additional negative tests not being counted, which increases positivity rates.
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The Iowa Department of Public Health notified nursing homes this week that it will not help them adhere to new federal requirements to frequently test all staff members for coronavirus.

The state has not been conducting routine surveillance testing of long-term care facility staff, according to the governor’s office, nor does it have requirements for how often testing must occur in facilities.

Now the federal government is mandating frequent testing of all nursing home staff based on the area’s test positivity rate. The U.S. Department of Health and Human Services has started sending rapid antigen testing equipment to long-term care facilities. But it’s not clear how many facilities have received it, and one facility in Fort Dodge only received enough supplies for a few rounds of testing.

As nursing homes are trying to obtain more test materials and funding to comply, a Sept. 16 memo from IDPH informed them that the State Hygienic Lab doesn’t have the capacity to step in and conduct routine testing for all facilities.

“As we have since the start, IDPH and SHL will continue to conduct testing in facilities when staff or residents become symptomatic, or when cases are identified,” says the IDPH memo, which was sent to media by the Iowa House Democrats. “However, the volume and frequency that will be generated by the new requirement for routine staff testing, in addition to the testing already occurring across the state, will exceed the current capacity of SHL.”

Gov. Kim Reynolds’ office estimates the newly-required testing could amount to more than 130,000 additional tests per week just from long-term care facilities.

At a news conference Wednesday, SHL Director Michael Pentella said the state lab is processing an average of 5,000 coronavirus tests per day, or about 35,000 per week.

The memo instructs nursing homes to “document their attempts to perform and/or obtain testing in accordance with the guidelines” to help them avoid penalties for not meeting testing requirements.

Surveillance testing of nursing home staff is meant to prevent some of the most vulnerable people from getting infected with the coronavirus.

As of Thursday afternoon, the state was reporting 658 long-term care facility residents in Iowa had died of COVID-19, making up more than half of the state’s total COVID-19 deaths. There are currently coronavirus outbreaks in 39 long-term care facilities across the state.

Julie Thorson, the president and CEO of a Fort Dodge senior living community called Friendship Haven, said she thinks the state should be helping them meet the testing requirements.

“IDPH and the SHL have made it clear to us even before the memo they are unable to assist with surveillance testing,” Thorson said in an email. “[The U.S. Centers for Medicare & Medicaid Services] believes the federal government has already provided federal relief to cover the cost of surveillance testing. It is not enough. Bottom line, we are left holding the bag with no long term plan to cover the cost.”

She said IDPH, the SHL and Webster County Public Health have helped test symptomatic residents and staff.

In a recent virtual news conference with LeadingAge, a national group representing nonprofit aging services, Thorson called for more federal funding to help meet the testing requirements.

“Because of our county’s positivity rates, we are going to have to test all of our employees twice a week,” Thorson said. “One test kit is $33, and that’s if we can find the test kits. If we don’t, we’re expected to work with outside laboratories at a cost of $100 a test.”

She said if one employee tests positive, all residents will have to be tested. She said that cycle could continue indefinitely.

“The cost is unsustainable,” Thorson said. “We need more help.”

An IDPH spokesperson has not responded to Iowa Public Radio’s questions about how many long-term care facilities in Iowa have received testing equipment from the federal government.

Katarina Sostaric is IPR's State Government Reporter