The U.S. Department of Health and Human Services (HHS) is in the process of distributing 2.6 million COVID-19 testing kits to organizations that serve vulnerable populations, including hospice providers. In addition to hospices, the department is also sending a portion of those tests to assisted living facilities, nursing homes and home health organizations.
Many providers have struggled to obtain sufficient amount of testing equipment, as they have with other essential supplies such as personal protective equipment (PPE). This HHS distribution comes shortly after the U.S. Centers for Medicare & Medicaid Services issued an interim final rule requiring hospice staff and others who need access to nursing homes to be tested regularly in order to enter those facilities.
Thus far in the pandemic, nursing homes have taken priority as the federal health agencies scramble to ramp up virus testing.
“A very important component of this is to shield the elderly. Shielding the elderly has been and will continue to be a priority for the administration because they really bear the brunt of mortality and morbidity,” said Admiral Brett P. Giroir, M.D., assistant secretary for health at HHS. “On July 14, we announced that every single eligible nursing home would receive a point-of-care instrument and testing supplies. We have delivered on that promise; all 13,850 eligible nursing homes have received a total of 13,995 instruments and over 4.9 million rapid point of care tests.”
About 18% of hospice care in the United States is delivered in nursing homes, according to the National Hospice & Palliative Care Organization (NHPCO). Only private residences and assisted living facilities exceed that percentage as 55% and close to 20%, respectively.
The nursing home sector has been hit particularly hard by the pandemic, with more than 230,000 confirmed cases in that setting nationwide, along with more than 123,000 suspected cases and nearly 55,000 COVID-19 deaths.
Consequently, nursing homes have implemented strict restrictions on who can enter their buildings, as well as the circumstances and conditions in which an individual may enter. This has led to significant difficulty for many hospices that are trying to access their patients in those facilities and hampers their ability to provide respite care in nursing homes or hospitals.
The prevalence of the virus in a given region, usually determined by county, is another consideration HHS uses when allocating testing resources.
Stakeholders in the hospice space have been calling for additional aid when it comes to COVID-19 testing. NHPCO recently wrote to HHS Secretary Alex Azar requesting $500 million in federal dollars to support testing among hospice providers.
“[NHPCO] has heard from many state hospice and palliative care organizations and countless hospices across the nation that the need for immediate support to expand hospice testing capacity continues to grow to prevent the spread of this deadly virus,” the advocacy group indicated in the letter.“ In addition to the need for additional funds, hospices also need the Administration’s assistance with the acquisition of testing supplies which are in very limited supply when available at all.”