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Arizona Long-Term Care Facilities Still Struggling With PPE Shortage, Testing

Published: Tuesday, September 8, 2020 - 12:10pm
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LAUREN GILGER: And now we turn our attention to long-term care facilities. Last week, Maricopa County reached a grim milestone: More than 1,000 residents in long-term care have now died from the coronavirus. Joining me this morning to talk about what’s happening in these types of congregate settings is KJZZ's Kathy Ritchie. Good morning, Kathy.

KATHY RITCHIE: Good morning

GILGER: So, our numbers of new COVID-19 cases are going down in the state, we’re starting to see certain businesses slowly reopening, but people are still dying in long-term care facilities. It’s almost as though they are in a bubble separate from the rest of the state. 

RITCHIE: Well, in many ways they are. You know, we’re seeing this, to an extent, in universities. COVID-19 spreads like wildfire in congregate settings. The difference is, older adults are more likely to have poor outcomes if they get infected with the virus. But it’s difficult to keep out, which is why we saw long-term care facilities close their doors. I talked to Donna Taylor, the chief operating officer for Lifestream; they operate four senior living communities in Phoenix. And she touched on just how fast this virus moves

"We have had cases — I just saw how fast one person who is asymptomatic is in the building, and how quickly it can spread because I went from one asymptomatic employee to six infected residents and five more infected employees inside of 15 days," Taylor said.

GILGER: OK, so we’re six months into this. So, what’s this like for these long-term care operators, like Donna? And what are the next steps? You reported that nursing homes will soon be opening their doors to family after all this time.

RITCHIE: While I can’t speak for every long-term care setting — and there are a lot of them in our state — my understanding is that they’re exhausted. They have really struggled to get critical items like PPE, staffing has always been an issue even before the pandemic — I’ll get to that shortly — and now ongoing testing, another challenge. But let me circle back to those family visits. Donna Taylor sat on Gov. Doug Ducey’s task force that came up with the recommendations to reopen. She voted to move ahead with those recommendations and I’ll let her explain her vote to reopen.

"But when I looked at what was happening with our residents, those who are our elders living with dementia were declining in their speech and in their walking," Taylor said. "Our residents were losing weight, we were having higher complaints of pain. So that such that we were having to increase medications. These are all things that we have worked so very hard to decrease over the years… We just could no longer be OK with it. And so we came up with what I will say is an imperfect solution."

GILGER: And that imperfect solution comes with risks, I’m guessing.

RITCHIE: Absolutely. Families who want to go inside the building must take a COVID test within 48 hours of their visit. Then, they must quarantine themselves while they wait for those results. Taylor and all facilities had to complete their policies and procedures by [Sept. 4], which included the testing requirement to go inside.

"And that even just over this weekend after we issue that out to our family members, I got multiple emails from the family saying, 'Where do you think we're going to get this test? And is Lifestream going to be paying for this test? And or is there a place where we can get it for free?'" Taylor said.

GILGER: Let’s shift to talk about some of the challenges these places faced early on in the pandemic: PPE and staff.

RITCHIE: Yeah. PPE is still a challenge.  It’s very expensive. And you burn through PPE fast with COVID. So with the upcoming flu season and not knowing if you’re dealing with COVID or flu, some places could see their PPE stockpile depleted. The federal government has shipped rapid antigen testing kits to nursing homes and assisted living facilities across the country, so that will help, but they only have a finite number of tests. David Voepel is the CEO of the Arizona Health Care Association.

"Once you run through those hundred kits, if you have one right now and you've blown through your hundred kits, they're on backorder for about four to five weeks from what we're hearing from the manufacturers," Voepel said.

RITCHIE: So as Voepel put it, truly, if it's not one thing, it’s another. And that’s hard because my understanding is the Centers for Medicare and Medicaid have said facilities must start testing weekly. 

GILGER: What about staff, Kathy? We know this work is hard, it's demanding and these workers are minimum-wage workers.

RITCHIE: Yes. We’re talking about people who on average make $12, $13 an hour. Some have been getting overtime or hero pay, but the work can be relentless. And that’s where families come in. They often help with certain tasks like dressing or feeding.

GILGER: Have facilities reopened yet? 

RITCHIE: They had to have their policies and procedures ready to go by [Sept. 4]. And every facility is different. Donna Taylor said they will have their first visitor on Thursday, Sept. 17, so we’ll see how it all goes. 

GILGER: KJZZ's Kathy Ritchie. Thanks.

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