Deaths in nursing homes spur officials to increase testing, bolster staff levels

A brick building behind a sign.
St. Therese Senior Services in New Hope on April 30, 2020. The assisted living facility has seen dozens of deaths related to COVID-19.
Evan Frost | MPR News

As the number of deaths in long-term care facilities from COVID-19 has grown, so too has the pressure to address the issue. Minnesota officials say they have a new plan to try to get a better handle on the problem after hundreds of older adults have died. The plan includes more testing of a population the state already targeted for screening.

“Residents of long-term care facilities account for a little under 1 percent of Minnesota’s population. However, they account for 15 percent of Minnesota’s COVID-19 cases, 23 percent of the hospitalizations and very, very startlingly, 80 percent of the COVID-19 deaths that we’ve seen in our state,” said Minnesota Health Commissioner Jan Malcolm on Thursday.

As of Thursday, 407 of the 508 people who have died of COVID-19 in Minnesota lived in long-term care or assisted living facilities.

“Just the reality of the progression of this epidemic around our state probably means that many many more facilities are going to see cases, but we want to keep it in the one to three range and not see so many cases with 10, 20 and more cases,” Malcolm said.

Until now, state officials recommended no visitors, and advised nursing home operators to screen staff and residents each day for coronavirus symptoms. Testing was available for those showing symptoms, but not for people who were asymptomatic. As it turns out, some were infectious, too.

Malcolm said it’s time for a new testing policy.

“Expanding testing to all symptomatic residents and staff, as well as — and this is a big change for us — a plan for facilitywide testing when a case is confirmed or when multiple people develop symptoms.”

Screening of residents will be upped to several times a day, with oxygen level tests, a key indicator of COVID-19.

Many in the industry and at the state Capitol have been calling for more testing, including Sen. Karin Housley. The Republican from St. Mary’s Point made similar recommendations in a letter sent to MDH earlier this week.

“I'm disappointed that we didn't start testing staff weeks ago like I suggested. But I'm glad they're at least going to start doing it right now,” Housley said.

The state’s plan will create teams that will quickly conduct on-site testing and follow up with facilities.

It will send personal protective equipment to long-term care centers facing outbreaks and keep a stock of backup supplies. Another key aspect is staffing.

“We’ve been working really hard to try to support facilities when they hit crisis. When all of their workers or the majority of workers are out sick,” Malcolm said. “Or when they have staff who are afraid to come to work, who walk off the job because of their fear. And we’ve done that on several occasions.”

Malcolm said the state will try to tap health care workers to backfill when nursing home employees are out.

She also says they will use databases to help match volunteers with needs, as well as use incentives to encourage health systems to provide crisis staffing. Even the National Guard might be called.

“It's clear to us that Gov. Walz, Commissioner Malcolm really did hear the call from the care-giving community for a deeper collaboration and particularly to address the need for more staffing. And our need for personal protection equipment for our workers,” said Gayle Kvenvold, the president and CEO of LeadingAge Minnesota, a group representing long-term care and assisted living facilities in the state.

She said staffing is a huge need, and LeadingAge has partnered with other organizations to launch a website to recruit laid off workers from other industries to come work in long-term care.

“It's very good to hear that there will be a concerted strategy for how to bridge those emergency situations, as well as more comprehensive solutions for how we can attract more people to our field,” she said.

The plan will be implemented over the next few weeks.