Letter to Vice President Pence re: PPE Supplies to Nursing Homes

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Two (2) Senators – Ron Wyden (Ranking Member, Finance Committee) and Robert Casey (Ranking Member, Committee on Aging) have addressed a 10-page letter to VP Pence to “reiterate our deep concern that the Trump Administration’s continued failure to secure and distribute personal protective equipment (PPE) leaves nursing homes without the resources necessary to protect residents and workers from the novel coronavirus (COVID-19). Masks, gloves, gowns, and other PPE are the armor that nursing home workers wear into battle against COVID-19, and their continued scarcity in nursing homes around the country puts residents and the workers who care for them at unneeded risk.”

“Nursing homes and other congregate settings have been at the epicenter of the COVID-19 pandemic since the beginning. According to media reports, more than 70,000 nursing home residents and workers have lost their lives to COVID-19, and more than 420,000 have been infected.  Moreover, Federal data show that there are now more nursing home residents currently infected with COVID-19 than there were at the end May, making the persistent and increasing prevalence of PPE shortages in nursing homes all the more alarming.  Researchers have found that PPE shortages have resulted in health care workers unnecessarily contracting COVID-19.  PPE shortages also contribute to reductions in available health care services, as providers strive to preserve limited PPE supplies, putting additional strain on an already overloaded system.  With supply shortages worsening, nursing home residents and workers are under growing threat from COVID-19.”   (The letter contains the references to the data cited.)

Table 2 shows the Nursing Homes Reporting No Current Supply or No One-Week Supply of One or More PPE Type as of July 5, 2020 and August 9, 2020.

I encourage you to view this Table to see where your state falls in this data provided by CMS.

There are additional graphs and verbiage that you’ll want to review and share with your colleagues.

The Senators end their letter with a request for information:

“In light of the data provided to CMS by nursing homes showing that PPE supply is a persistent and growing problem, please answer the following questions no later than September 9, 2020:

1. A recent Health Affairs article that analyzed CMS’s PPE supply data found that “for profit nursing homes reported substantially higher rates of PPE shortages than other facilities.”  What is CMS doing to ensure that for-profit homes are maintaining adequate PPE supplies at their facilities?

2. Given CDC’s expectation that COVID-19 transmission will worsen in the Fall, what steps does the Trump Administration plan to take to bridge supply shortages at nursing homes and in other congregate settings? Does the Trump Administration plan to distribute supplies in the coming weeks to help facilities build stockpiles? In particular, please provide information regarding how the Trump Administration determined which nursing homes will receive the announced delivery of N95 masks.

3. The Finance Committee recently received testimony from Rob Wiehe, the Chief Supply Chain and Logistics Officer at UC Health in Cincinnati, who recommended that health systems and hospitals should be required to carry at least 30 days of critical PPE.   Does the Administration plan to issue any guidance for nursing homes regarding the amount of PPE they should have on hand during the COVID-19 pandemic or other public health emergencies?

4. Since the beginning of the COVID-19 pandemic, “burn rates” of PPE, i.e., the amount a facility uses, have dramatically increased, in some cases by a factor of 10 or more.   As such, what once may have been an adequate one-week supply of PPE may not be enough even for one day for a facility battling the virus. CMS and CDC do not appear to have defined how much a “one-week supply” of PPE is in its nursing home data collection requirements. Will the Administration issue guidance to nursing homes to somehow quantify, or otherwise make clearer, what a “one-week supply” of PPE actually means?

5. Long-term care facilities that house Black and Latino residents are more likely to have been hit by COVID-19 than ones that house White residents.   Has the Administration used demographic data to determine if PPE shortages are disproportionately impacting nursing homes serving these or other minority communities?”

All LTCFs await these answers – and assistance – as well!