Maryland to stop paying for mandatory coronavirus testing for nursing home staff

Maryland Gov. Larry Hogan (R) has warned the state is facing a serious financial crisis. (Michael S. Williamson/The Washington Post)

By Rebecca Tan and Rachel Chason

Maryland’s health department has warned nursing homes that the state will soon stop paying for the weekly coronavirus testing it requires for staff — prompting frustration from some in the industry, who say facilities cannot afford to foot the bill.

State officials say nursing homes should be able to pay for the tests through funding they received from the federal Cares Act. But industry advocates say there is not enough money to cover those costs and other pressing pandemic-related needs, especially for small, independent facilities.

“This is not something that [nursing homes] are set up to be able to continue on their own,” said Allison Ciborowski, chief executive for LeadingAge Maryland, which represents 120 nonprofit operators of long-term care facilities.

She added that it is vital for the state to ensure regular testing at long-term care facilities, where the coronavirus has already killed more than 2,000 staff and residents.

“This will crush us,” says the Rev. Derrick DeWitt, director of Maryland Baptist Aged Home in Baltimore, about figuring out how to pay for testing. (Marvin Joseph/The Washington Post)

Maryland has required since mid-June that nursing homes test all staff weekly, and offered to pay for facilities that were unable to afford it. Last week, however, the health department informed industry advocates that the state would stop conducting and sponsoring employee testing. The agency said facilities should establish their own testing arrangements with laboratories by Aug. 14.

In response to questions about what would happen to facilities that do not have the funds, Mike Ricci, a spokesman for Gov. Larry Hogan (R), said: “We expect the vast majority of facilities to have plans in place, but there’s a range of options depending on the situation.” He said the state will continue paying for testing for residents at facilities where there are coronavirus outbreaks.

Hogan on Tuesday said the state is facing its worst economic crisis since the Great Depression and warned that state agencies may be asked to cut their budgets by 15 to 20 percent.

The federal government in May distributed $4.9 billion to 15,000 Medicare-certified skilled nursing facilities. Facilities with more than six residents were eligible for a baseline amount of $50,000, along with $2,500 per bed. This month, the government added $5 billion in relief funding for nursing homes.

In a Friday letter to three nursing home trade associations, state health officials said they “fully expect that your member facilities will make use of those funds to protect your residents from COVID-19 by continuing weekly mandated testing.”

State health secretary Robert Neall released an order that day outlining the requirements and saying failure to comply is a misdemeanor. Maryland has fined multiple nursing homes for failing to meet requirements related to testing.

Nationally, some lawmakers and watchdog groups have expressed concern with how nursing homes are using the federal funding, calling for more government scrutiny. Ciborowski said her organization’s members are following all relevant guidelines.

Ciborowski said it is not immediately clear whether testing staff is an eligible expense under the Cares Act. The Department of Health and Human Services did not respond to questions seeking clarification.

Even if facilities can use federal funding to pay for tests, what they have received is “simply not enough” to cover weekly testing on top of other expenses such as additional protective equipment and hazard pay for employees, said Joseph DeMattos Jr., chief executive of the Health Facilities Association of Maryland.

Philip Meyer, who owns the 50-bed Althea Woodland facility in Montgomery County, said it is “ridiculous” for the state to make facilities use their federal funding to pay for weekly testing of staff.

The $175,000 in Cares Act money that Althea Woodland received in May has gone toward paying employees and operating costs while revenue declined, and buying protective equipment, he said. The state’s decision to stop sponsoring employee testing, he added, “will wreak havoc on an already over-burned industry.”

At Maryland Baptist Aged Home, a 29-bed nonprofit facility in Baltimore that has had zero coronavirus cases, leaders are scrambling to figure out how to pay for their own testing. “This will crush us,” said Rev. Derrick DeWitt, who serves as the facility’s director.

DeMattos said shifting responsibility for testing to individuals nursing homes also means tests will likely be sent to commercial labs, which are experiencing nationwide backlogs. The state lab has generally turned around results more quickly, he said.

Nursing homes in Virginia and the District will also soon need to begin paying for regular testing, industry advocates said, although there have not been orders stating when funding will be cut.

In Virginia, the state organized and paid for a round of testing and is now shifting responsibility to the facilities, said Amy Hewett, spokeswoman for the Virginia Health Care Association. State guidance says all staff and residents should be tested weekly in the first phase of reopening, until there are no new cases among residents for 14 days. But it is a recommendation, not a mandate.

In the District, the city had been paying for required weekly testing. On Monday, however, one nursing home said it was asked to begin organizing and paying for its own testing, said Veronica Sharpe, president of the D.C. Health Care Association. She said she will ask the city for more funding if it expects nursing homes to pay for their own testing.

Correction: A previous version of this story said Maryland is set to stop paying for coronavirus testing of nursing home staff and residents. It only plans to stop paying for the mandatory weekly testing of staff.

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Maryland to stop paying for mandatory coronavirus testing  for nursing home staff