Analysis: La. nursing homes have vulnerability from staff
BATON ROUGE, La. (AP) — As Louisiana tries to protect vulnerable nursing home residents from coronavirus outbreaks, the facilities still have a significant source of risk for new infections. Hundreds of employees coming and going each day have refused to take a virus test.
Gov. John Bel Edwards’ administration ordered nursing homes to regularly test residents and workers for the COVID-19 disease caused by the coronavirus or face financial penalties. But while nursing homes have to provide the testing, residents and staff can refuse to participate.
Testing refusals haven’t been a problem with residents, according to the latest data provided to The Associated Press by the Louisiana Department of Health, which shows all but a few of the state’s nearly 24,000 nursing home residents have been tested for COVID-19.
But 700 employees of the facilities had spurned the available testing in the July 22 data.
Testing refusals represent only 2% of Louisiana’s nearly 31,000 nursing home workers, but they still offer hundreds of ways the coronavirus can enter nursing homes through some of the only people allowed to enter and exit the facilities on a regular basis. Nursing homes are closed to visitors.
The coronavirus pandemic ravaged Louisiana’s nursing homes in the earliest days of the state’s outbreak, and the facilities — packed with elderly residents most at-risk for serious effects from the virus — remain one of the most susceptible settings to rapidly spreading infections.
More than 1,600 Louisiana nursing home residents have died from COVID-19, more than 40% of the state’s deaths from the disease, according to health department data.
The department didn’t provide a list of specific nursing homes where employees have rejected testing, but the agency’s data shows they work in three of the state’s nine health regions — the New Orleans, Baton Rouge and Monroe regions. Of the 700 workers who refused tests, 338 work in the four-parish New Orleans region, representing about 9% of the nursing home employees in the area.
Louisiana announced in mid-June that it had toughened its coronavirus testing requirements for nursing homes, after some facilities didn’t follow earlier voluntary testing standards recommended by the state. Nursing homes that don’t follow the testing policy face the risk of restrictions on admitting new patients, civil penalties or withholding of Medicaid payments.
“Our testing approach has been to ensure that every patient inside a nursing home is tested for COVID-19 at least once, and then to support facilities with regularly testing of staff on a weekly basis,” department spokesman Kevin Litten said in a statement.
Any staff member who tests positive must isolate and not enter the nursing home while contagious, Litten said. Any nursing home that has an employee test positive must do a new round of patient testing to determine if there are new infections in the facility.
The health department hasn’t explicitly called for workers who refuse testing to be fired — but it warns in its testing policy that those employees put “residents and the employer at risk if they continue to work at the facility.”
Litten said the department’s heard several reasons for nursing home employees rebuffing the tests. He said some workers seem to object to the invasive testing procedure, while others aren’t at work on testing day or are already isolating because of a previous positive test.
Some people work at multiple nursing homes and don’t need to get tested at both locations. People who have tested positive, isolated and then returned to work after symptoms disappear also aren’t usually asked to test again, Litten said.
But he said some nursing home employees may be refusing because they worry they’ll test positive and lose their income by having to stay home and quarantine.
Mark Berger, executive director of the Louisiana Nursing Home Association, said the organization’s member facilities have adopted policies to address workers who won’t get tested for the virus, which can include placing the employee on leave or firing them.
“While the policies are specific to the individual facility, the overall goal of all facilities is to protect the health, safety and well-being of the residents,” Berger said in a statement.
He noted 98% of workers have undergone testing: “This is an incredibly high testing percentage, especially considering the refusal number may include individuals who previously tested positive and have fully recovered.”
Still, testing refusals leave cracks in efforts to keep nursing home residents safe in the pandemic.
EDITOR’S NOTE: Melinda Deslatte has covered Louisiana politics for The Associated Press since 2000. Follow her at http://twitter.com/melindadeslatte