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Nursing homes say R.I. was slow to test at outset of pandemic

R.I. Health Care Association responds to Governor Raimondo's comments, saying nursing homes were "climbing uphill"

Scott Fraser, president and CEO of the Rhode Island Health Care Association, said state officials were slow to help nursing homes combat the spread of COVID-19.
Scott Fraser, president and CEO of the Rhode Island Health Care Association, said state officials were slow to help nursing homes combat the spread of COVID-19.Jonathan Wiggs/Globe Staff

PROVIDENCE — Rhode Island was slow to start coronavirus testing on patients coming from hospitals to nursing homes, it was slow to test nursing home workers and residents, and even now it is slow in providing test results.

Those were some of the statements that the Rhode Island Health Care Association made Friday in responding to Governor Gina M. Raimondo’s proposals to revamp long-term care and make the state’s nursing homes “better, stronger, and safer.”

“Rhode Island’s nursing homes and our workers fought tirelessly against this virus, yet without the proper tools and support, they were climbing uphill,” president and CEO Scott Fraser said in a statement. The Health Care Association represents 64 nursing homes in Rhode Island.

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As of June 26, 73 percent of Rhode Island’s COVID-19 deaths have been “associated with” nursing homes, and the impact on nursing home residents has been the focus of scrutiny and criticism.

During a news conference Wednesday, Raimondo said the pandemic has forced the state to rethink the way that long-term care services are delivered. She said the state is providing additional funding to nursing homes for personal protective equipment and cleaning supplies, but it will also be ramping up inspections to ensure nursing homes are safe.

On Friday, Fraser issued a statement, saying, “Rhode Island’s nursing homes are listed as number one in infection control and ranked second in quality in the nation, making us among the best, strongest and safest homes in the country.”

Rhode Island has one of the older state populations in the country, so it’s no surprise the virus would take a toll on nursing homes, which contain 7,500 of the state’s most ill and frail residents, he said.

As the pandemic emerged, the Health Care Association remained in contact with state health officials, letting them know about needed testing and supplies, Fraser said. “Many requests were answered,” he said, “but some critical needs were slow in coming.”

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For example, he said, the association asked the state to test hospital patients for COVID-19 before they were transferred into nursing homes, but the state took weeks to begin that testing.

“The insertion of untested hospital patients is what brought the first cases of COVID-19 into the nursing homes,” the group said.

The association said it pushed for expanded, rapid testing in nursing homes because it’s nearly impossible to isolate residents and workers from a virus that can be spread by people who show no symptoms. But, the group said, “This critical testing of residents and workers was slow to be implemented.”

Regular testing is taking place now, but results can still sometimes take between six and 10 days, “rendering many results unusable,” the association said.

Also, Fraser said nursing homes at first had a hard time getting the necessary amount of face masks and other personal protective equipment needed to combat the spread of the virus. Now, nursing homes have the equipment they need, but, he said, “in the initial two months, homes were in crisis.”

While nursing homes have now received funding and more regular testing, Fraser said, “These initial months had a big impact on how this virus played out in Rhode Island nursing homes.”

Fraser said nearly three-quarters of the 2,745 people who have contracted COVID-19 in Rhode Island nursing homes have recovered. “Our homes are celebrating these recoveries week after week,” he said.

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The association is willing to talk to state officials about innovations in long-term care, Fraser said. But he noted Medicaid patients account for two-thirds of nursing home residents, and he said that since 2012, the state has cut the Medicaid budget nearly every year, “forcing many homes to operate at the financial edge.”

“If the Governor is willing to replenish the Medicaid budget after significant cuts and UHIP (Unified Health Infrastructure Project) reimbursement issues, and provide more funding for single rooms and home care – this would be a welcome change,” he said.

In response to the Health Care Association statement, Department of Health spokesman Joseph Wendelken said, “We are grateful for the partnership of all the long-term care facility administrators throughout this response, as well as the partnership of their professional organizations.”

He said Rhode Island was one of the first states to begin “aggressive cyclical testing” in nursing homes, and state outbreak response teams rush to nursing homes within hours of receiving reports of multiple COVID-19 reported cases.

The State Health Laboratories has a “very fast turnaround time” for test results, Wendelken said. And, he said, “As we continue to support facilities, we are working to ensure that the private labs that are also testing nursing home residents get results back to administrators as soon as possible.”


Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com